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CPT code 68328: Eyelid lining repair, graft reconstruction2026 Medicare rate & RVUs

Reconstructs the conjunctival lining of the eyelid or fornix with a graft, typically to address scarring and tissue loss that impair eyelid function.

CMS RVU26DEffective Oct 1, 2026109 payment localities65 Medicare services in 2024

Medicare pays $598.88 for 68328 nationally in a facility.

Medicare rate · 68328

Eyelid lining repair, graft reconstruction

Office or facility?

Work RVUs
9.21
Total RVUs
17.93
Global days
090

National rate · 2026

$598.88

Facility setting, before claim adjustments.

See every locality for 68328 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 68328 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 68328 covers

An ophthalmologist, often an oculoplastic or ocular surface surgeon, uses a graft to rebuild damaged conjunctival lining and restore the eyelid’s inner surface or fornix. Common situations include cicatricial contraction after trauma, burns, prior surgery, or chronic inflammation, when scarring or tissue loss limits eyelid movement or ocular surface protection. These reconstructions are generally performed in an operating-room setting.

Select this code when the operative service includes graft-based reconstruction of the eyelid lining; document the affected anatomy, the reason reconstruction is needed, and the graft used. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 68328 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

68328 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$554.94
AlaskaUnavailable$759.09
ArizonaUnavailable$587.09
ArkansasUnavailable$549.42
Atlanta, GAUnavailable$608.97
Austin, TXUnavailable$612.19
Bakersfield, CAUnavailable$620.81
Baltimore area, MDUnavailable$629.06
Beaumont, TXUnavailable$573.13
Brazoria, TXUnavailable$593.57

68328 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
68328 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 68328 rate is calculated

Each of 68328’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 68328

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.21

9.21 RVUs× 1.000 GPCI

Practice expense7.99

7.99 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

17.9300

Conversion factor

$33.4009

Medicare rate

$598.88

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 68328

68328 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68328

Eyelid lining repair, graft reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68328

Eyelid lining repair, graft reconstruction

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68328 without 50 · national facility

$598.88

Eyelid lining repair, graft reconstruction

68328-50 · Bilateral: 150%

$898.32

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

68328 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 68328

    Eyelid lining repair, graft reconstruction9.21 wRVU

    Not priced

  • 68320

    Conjunctivoplasty, graft or extensive rearrangement6.47 wRVU

    $747.18

  • 68325

    Conjunctivoplasty, mucous membrane graft8.41 wRVU

    Not priced

  • 68326

    Fornix reconstruction, with mucous membrane graft8.21 wRVU

    Not priced

  • 68335

    Symblepharon repair, with graft8.25 wRVU

    Not priced

How to choose

68320ConjunctivoplastyGraft or extensive rearrangement
68320 is the related reconstruction approach without a graft. Use 68328 when the documented procedure includes graft-based lining reconstruction.
68325ConjunctivoplastyMucous membrane graft
Both are related cul-de-sac reconstruction codes, but the appropriate code depends on the graft type or technique documented for the procedure.
68326Fornix reconstructionWith mucous membrane graft
This is a related graft-reconstruction code with a distinction based on graft type or technique; follow the operative details when choosing between it and 68328.
68335Symblepharon repairWith graft
68335 is directed to graft repair of symblepharon. Choose 68328 when the documented service is graft reconstruction of the eyelid lining rather than that symblepharon repair.

Codes related to 68328

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 68328
CodeHow it relatesNational office range
Same family
68320Conjunctivoplasty, graft or extensive rearrangementRelated conjunctival reconstruction without a graft.$666.44–$990.25
68325Conjunctivoplasty, mucous membrane graftRelated cul-de-sac reconstruction code distinguished by graft type or technique.No office rate
68326Fornix reconstruction, with mucous membrane graftRelated cul-de-sac reconstruction code distinguished by graft type or technique.No office rate
Used instead
68330Symblepharon repair, without graftUsed for eyelid-lining revision without the graft reconstruction described by 68328.$557.46–$823.85
68335Symblepharon repair, with graftGraft repair directed to symblepharon rather than the reconstruction represented by 68328.No office rate
68340Adhesion release, eyelid adhesionsSeparates conjunctival adhesions rather than rebuilding the lining with a graft.$549.78–$823.54

68328 billing questions

How does 68328 differ from 68320?

68328 describes reconstruction using a graft. 68320 is a related reconstruction code without a graft; the operative report should establish which approach was performed.

How do I choose between 68328 and 68325 or 68326?

These are related reconstruction codes with distinctions tied to graft type or technique. Use the code that matches the documented graft and procedure rather than choosing by diagnosis alone.

What documentation supports 68328?

Document the eyelid or fornix anatomy reconstructed, the scarring or tissue loss prompting surgery, the reconstruction performed, and the graft used.

How is bilateral 68328 reported?

When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. CMS does not permit co-surgeon or team-surgery payment for this code.

What happens when 68328 is performed with another procedure in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 68328PPRRVU2026_Oct_nonQPP.csv, line 7,544 (RVU26D)

Open CMS sourceHow we calculate rates

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