CPT code 68328: Eyelid lining repair, graft reconstruction2026 Medicare rate & RVUs in Virginia
Reconstructs the conjunctival lining of the eyelid or fornix with a graft, typically to address scarring and tissue loss that impair eyelid function.
In Virginia, Medicare pays $587.17 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.
On this page 11 sections
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 Virginia 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. Virginia pays $587.17. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$587.17
- Los Angeles, CA · California$652.14+$64.97
- Washington, DC area · District of Columbia$665.75+$78.58
- Miami, FL · Florida$647.10+$59.93
- Chicago, IL · Illinois$633.94+$46.77
- Manhattan, NY · New York$676.09+$88.92
- Alaska · Alaska$759.09+$171.92
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $554.94 |
| ArkansasArkansas | — | $549.42 |
| ArizonaArizona | — | $587.09 |
| Bakersfield, CACalifornia | — | $620.81 |
| Chico, CACalifornia | — | $618.41 |
| El Centro, CACalifornia | — | $618.54 |
| Fresno, CACalifornia | — | $618.41 |
| Hanford, CACalifornia | — | $618.41 |
| Madera, CACalifornia | — | $618.41 |
| Merced, CACalifornia | — | $618.41 |
| Modesto, CACalifornia | — | $618.41 |
| Napa, CACalifornia | — | $691.13 |
| Oxnard, CACalifornia | — | $646.87 |
| Redding, CACalifornia | — | $618.41 |
| Rest of CaliforniaCalifornia | — | $618.41 |
| Riverside, CACalifornia | — | $626.45 |
| Sacramento, CACalifornia | — | $642.14 |
| Salinas, CACalifornia | — | $639.53 |
| San Diego, CACalifornia | — | $649.25 |
| Marin County, CACalifornia | — | $724.33 |
| San Francisco, CACalifornia | — | $723.50 |
| San Benito County, CACalifornia | — | $739.36 |
| Santa Clara County, CACalifornia | — | $735.97 |
| San Luis Obispo, CACalifornia | — | $629.89 |
| Santa Cruz, CACalifornia | — | $651.40 |
| Santa Maria, CACalifornia | — | $640.48 |
| Santa Rosa, CACalifornia | — | $657.64 |
| Stockton, CACalifornia | — | $618.41 |
| Vallejo, CACalifornia | — | $689.93 |
| Visalia, CACalifornia | — | $618.41 |
| Yuba City, CACalifornia | — | $618.41 |
| ColoradoColorado | — | $614.31 |
| ConnecticutConnecticut | — | $630.70 |
| DelawareDelaware | — | $594.75 |
| Fort Lauderdale, FLFlorida | — | $622.05 |
| Rest of FloridaFlorida | — | $599.40 |
| Atlanta, GAGeorgia | — | $608.97 |
| Rest of GeorgiaGeorgia | — | $574.74 |
| Hawaii, Guam, HIHawaii | — | $625.17 |
| IowaIowa | — | $561.49 |
| IdahoIdaho | — | $564.68 |
| East St. Louis, ILIllinois | — | $602.25 |
| Rest of IllinoisIllinois | — | $589.39 |
| Suburban Chicago, ILIllinois | — | $627.06 |
| IndianaIndiana | — | $566.86 |
| KansasKansas | — | $561.16 |
| KentuckyKentucky | — | $567.18 |
| New Orleans, LALouisiana | — | $586.45 |
| Rest of LouisianaLouisiana | — | $567.16 |
| Metropolitan Boston, MAMassachusetts | — | $660.58 |
| Rest of MassachusettsMassachusetts | — | $612.99 |
| Baltimore area, MDMaryland | — | $629.06 |
| Rest of MarylandMaryland | — | $603.16 |
| Rest of MaineMaine | — | $568.31 |
| Southern Maine, MEMaine | — | $587.48 |
| Detroit, MIMichigan | — | $606.26 |
| Rest of MichiganMichigan | — | $578.81 |
| MinnesotaMinnesota | — | $589.45 |
| Metropolitan Kansas City, MOMissouri | — | $582.04 |
| Metropolitan St. Louis, MOMissouri | — | $586.12 |
| Rest of MissouriMissouri | — | $561.42 |
| MississippiMississippi | — | $555.42 |
| MontanaMontana | — | $598.83 |
| North CarolinaNorth Carolina | — | $572.20 |
| North DakotaNorth Dakota | — | $584.39 |
| NebraskaNebraska | — | $563.16 |
| New HampshireNew Hampshire | — | $606.77 |
| Northern New JerseyNew Jersey | — | $662.62 |
| Rest of New JerseyNew Jersey | — | $638.10 |
| New MexicoNew Mexico | — | $581.63 |
| NevadaNevada | — | $595.07 |
| NYC suburbs and Long Island, NYNew York | — | $689.90 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $643.19 |
| Queens, NYNew York | — | $677.91 |
| Rest of New YorkNew York | — | $578.29 |
| OhioOhio | — | $575.86 |
| OklahomaOklahoma | — | $564.89 |
| Portland, OROregon | — | $627.18 |
| Rest of OregonOregon | — | $590.57 |
| Metropolitan Philadelphia, PAPennsylvania | — | $620.06 |
| Rest of PennsylvaniaPennsylvania | — | $575.65 |
| Puerto RicoPuerto Rico | — | $601.45 |
| Rhode IslandRhode Island | — | $610.90 |
| South CarolinaSouth Carolina | — | $574.94 |
| South DakotaSouth Dakota | — | $582.69 |
| TennesseeTennessee | — | $563.30 |
| Austin, TXTexas | — | $612.19 |
| Beaumont, TXTexas | — | $573.13 |
| Brazoria, TXTexas | — | $593.57 |
| Dallas, TXTexas | — | $597.12 |
| Fort Worth, TXTexas | — | $594.77 |
| Galveston, TXTexas | — | $595.28 |
| Houston, TXTexas | — | $608.64 |
| Rest of TexasTexas | — | $582.90 |
| UtahUtah | — | $580.38 |
| Virgin Islands, VIUnited States Virgin Islands | — | $601.45 |
| VermontVermont | — | $584.16 |
| Rest of WashingtonWashington | — | $611.19 |
| King County, WAWashington | — | $670.38 |
| WisconsinWisconsin | — | $570.80 |
| West VirginiaWest Virginia | — | $574.43 |
| WyomingWyoming | — | $592.54 |
68328 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,544
- Code
- 68328
- Physician work
- 9.21
- Practice expense
- 7.99
- Malpractice
- 0.73
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.21 | × 1.000 | 9.2100 |
| Practice expense | 7.99 | × 0.983 | 7.8542 |
| Malpractice | 0.73 | × 0.706 | 0.5154 |
| Total RVUs | 17.5796 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Virginia$587.17
Facility: (9.21 × 1 + 7.99 × 0.983 + 0.73 × 0.706) × $33.4009 = $587.17
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share 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.
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).
How 68328 has changed in Virginia
68328 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $587.17 | RVU26D |
| 2026-07-01 | Not available in this setting | $587.17 | RVU26C |
| 2026-04-01 | Not available in this setting | $587.17 | RVU26B |
| 2026-01-01 | Not available in this setting | $587.17 | RVU26A |
| 2025-10-01 | Not available in this setting | $665.64 | RVU25D |
| 2025-07-01 | Not available in this setting | $665.64 | RVU25C |
| 2025-04-01 | Not available in this setting | $665.64 | RVU25B |
| 2025-01-01 | Not available in this setting | $665.64 | RVU25A |
| 2024-10-01 | Not available in this setting | $684.27 | RVU24D |
| 2024-07-01 | Not available in this setting | $684.27 | RVU24C |
| 2024-04-01 | Not available in this setting | $684.27 | RVU24B |
| 2024-03-09 | Not available in this setting | $684.27 | RVU24AR |
| 2024-01-01 | Not available in this setting | $673.10 | RVU24A |
| 2023-10-01 | Not available in this setting | $693.93 | RVU23D |
| 2023-07-01 | Not available in this setting | $693.93 | RVU23C |
| 2023-04-01 | Not available in this setting | $693.93 | RVU23B |
| 2023-01-01 | Not available in this setting | $693.93 | RVU23A |
| 2022-10-01 | Not available in this setting | $701.91 | RVU22D |
| 2022-07-01 | Not available in this setting | $701.91 | RVU22C |
| 2022-04-01 | Not available in this setting | $701.91 | RVU22B |
| 2022-01-01 | Not available in this setting | $701.91 | RVU22A |
| 2021-10-01 | Not available in this setting | $706.48 | RVU21D |
| 2021-07-01 | Not available in this setting | $706.48 | RVU21C |
| 2021-04-01 | Not available in this setting | $706.48 | RVU21B |
| 2021-01-01 | Not available in this setting | $706.48 | RVU21A |
| 2020-10-01 | Not available in this setting | $717.29 | RVU20D |
| 2020-07-01 | Not available in this setting | $717.29 | RVU20C |
| 2020-04-01 | Not available in this setting | $717.29 | RVU20B |
| 2020-01-01 | Not available in this setting | $717.29 | RVU20A |
| 2019-10-01 | Not available in this setting | $717.64 | RVU19D |
| 2019-07-01 | Not available in this setting | $717.64 | RVU19C |
| 2019-04-01 | Not available in this setting | $717.64 | RVU19B |
| 2019-01-01 | Not available in this setting | $717.64 | RVU19A |
| 2018-10-01 | Not available in this setting | $720.02 | RVU18D |
| 2018-07-01 | Not available in this setting | $720.02 | RVU18C |
| 2018-04-01 | Not available in this setting | $720.02 | RVU18B |
| 2018-01-01 | Not available in this setting | $720.02 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $712.82 | RVU17D |
| 2017-07-01 | Not available in this setting | $712.82 | RVU17C |
| 2017-04-01 | Not available in this setting | $712.82 | RVU17B |
| 2017-01-01 | Not available in this setting | $712.82 | RVU17A |
| 2016-10-01 | Not available in this setting | $707.97 | RVU16D |
| 2016-07-01 | Not available in this setting | $707.97 | RVU16C |
| 2016-04-01 | Not available in this setting | $707.97 | RVU16B |
| 2016-01-01 | Not available in this setting | $707.97 | RVU16A |
| 2015-10-01 | Not available in this setting | $709.06 | RVU15D |
| 2015-07-01 | Not available in this setting | $709.06 | RVU15C |
| 2015-04-01 | Not available in this setting | $705.53 | RVU15B |
| 2015-01-01 | Not available in this setting | $705.53 | RVU15A |
| 2014-10-01 | Not available in this setting | $735.69 | RVU14D |
| 2014-07-01 | Not available in this setting | $735.69 | RVU14C |
| 2014-04-01 | Not available in this setting | $735.69 | RVU14B |
| 2014-01-01 | Not available in this setting | $735.69 | RVU14A |
| 2013-10-01 | Not available in this setting | $725.11 | RVU13D |
| 2013-07-01 | Not available in this setting | $725.11 | RVU13C |
| 2013-04-01 | Not available in this setting | $725.11 | RVU13B |
| 2013-01-01 | Not available in this setting | $725.11 | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
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
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