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

In Puerto Rico, Medicare pays $601.45 for 68328 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 68328 nationwide

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

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.

How Puerto Rico compares for 68328

Across 109 of 109 payment localities, the facility rate for 68328 runs from $549.42 in Arkansas to $759.09 in Alaska. Puerto Rico pays $601.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

68328 rates by state

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

See 68328 in every payment locality

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.

Payment rules and modifiers for 68328

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

What modifiers do to the payment

When to use modifier 50

Codes related to 68328

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

How 68328 has changed in Puerto Rico

Price 68328 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates