CPT code 68340: Adhesion release, eyelid adhesions2026 Medicare rate & RVUs in Kansas
Reports surgical division of adhesions involving the eyelid, such as lid-margin fusion that limits normal separation or movement of the lids.
In Kansas, Medicare pays $569.26 for 68340 in the office and $328.91 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 68340 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 68340 covers
This procedure releases abnormal scar tissue or other adhesions that bind eyelid structures together, including fusion at the lid margins. A typical clinical situation is acquired or congenital ankyloblepharon, where adhesions restrict opening or separation of the lids. An ophthalmologist, often an oculoplastic surgeon, performs the release in an operative setting; Medicare records services in both office and facility settings.
Report the code when the operative work is directed at separating eyelid adhesions, rather than reconstructing damaged eyelid lining. The note should identify the affected eyelid or lids, the location and extent of the adhesion, the functional or anatomic problem, and the release performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented 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 Kansas compares for 68340
Across 109 of 109 payment localities, the office rate for 68340 runs from $549.78 in Arkansas to $823.54 in San Benito County, CA. Kansas pays $569.26. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Kansas · this page$569.26
- Los Angeles, CA · California$701.69+$132.43
- Washington, DC area · District of Columbia$711.50+$142.24
- Miami, FL · Florida$673.93+$104.67
- Chicago, IL · Illinois$654.13+$84.87
- Manhattan, NY · New York$716.54+$147.28
- Alaska · Alaska$721.84+$152.58
Other areas in Kansas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $557.91 | $325.28 |
| ArkansasArkansas | $549.78 | $321.39 |
| ArizonaArizona | $605.50 | $347.87 |
| Bakersfield, CACalifornia | $658.79 | $367.39 |
| Chico, CACalifornia | $656.85 | $365.46 |
| El Centro, CACalifornia | $656.96 | $365.57 |
| Fresno, CACalifornia | $656.85 | $365.46 |
| Hanford, CACalifornia | $656.85 | $365.46 |
| Madera, CACalifornia | $656.85 | $365.46 |
| Merced, CACalifornia | $656.85 | $365.46 |
| Modesto, CACalifornia | $656.85 | $365.46 |
| Napa, CACalifornia | $760.97 | $410.55 |
| Oxnard, CACalifornia | $698.24 | $383.98 |
| Redding, CACalifornia | $656.85 | $365.46 |
| Rest of CaliforniaCalifornia | $656.85 | $365.46 |
| Riverside, CACalifornia | $664.00 | $372.61 |
| Sacramento, CACalifornia | $689.29 | $380.08 |
| Salinas, CACalifornia | $686.73 | $378.58 |
| San Diego, CACalifornia | $702.91 | $384.93 |
| Marin County, CACalifornia | $805.39 | $430.51 |
| San Francisco, CACalifornia | $804.64 | $429.76 |
| San Benito County, CACalifornia | $823.54 | $440.16 |
| Santa Clara County, CACalifornia | $820.48 | $437.09 |
| San Luis Obispo, CACalifornia | $675.70 | $372.87 |
| Santa Cruz, CACalifornia | $709.65 | $386.62 |
| Santa Maria, CACalifornia | $689.31 | $379.30 |
| Santa Rosa, CACalifornia | $716.80 | $390.31 |
| Stockton, CACalifornia | $656.85 | $365.46 |
| Vallejo, CACalifornia | $759.89 | $409.47 |
| Visalia, CACalifornia | $656.85 | $365.46 |
| Yuba City, CACalifornia | $656.85 | $365.46 |
| ColoradoColorado | $647.42 | $364.53 |
| ConnecticutConnecticut | $663.87 | $377.53 |
| DelawareDelaware | $615.58 | $352.90 |
| Fort Lauderdale, FLFlorida | $645.77 | $376.44 |
| Rest of FloridaFlorida | $614.07 | $359.89 |
| Atlanta, GAGeorgia | $634.19 | $364.06 |
| Rest of GeorgiaGeorgia | $579.16 | $342.01 |
| Hawaii, Guam, HIHawaii | $673.01 | $370.72 |
| IowaIowa | $571.72 | $328.45 |
| IdahoIdaho | $575.58 | $330.98 |
| East St. Louis, ILIllinois | $609.55 | $364.95 |
| Rest of IllinoisIllinois | $596.54 | $353.80 |
| Suburban Chicago, ILIllinois | $652.24 | $379.19 |
| IndianaIndiana | $578.94 | $332.48 |
| KentuckyKentucky | $571.74 | $335.38 |
| New Orleans, LALouisiana | $599.40 | $349.22 |
| Rest of LouisianaLouisiana | $570.94 | $335.64 |
| Metropolitan Boston, MAMassachusetts | $711.49 | $394.04 |
| Rest of MassachusettsMassachusetts | $643.60 | $363.64 |
| Baltimore area, MDMaryland | $662.07 | $376.79 |
| Rest of MarylandMaryland | $627.33 | $358.27 |
| Rest of MaineMaine | $578.87 | $334.27 |
| Southern Maine, MEMaine | $610.18 | $346.70 |
| Detroit, MIMichigan | $622.04 | $365.48 |
| Rest of MichiganMichigan | $586.98 | $344.24 |
| MinnesotaMinnesota | $619.45 | $345.87 |
| Metropolitan Kansas City, MOMissouri | $595.02 | $345.37 |
| Metropolitan St. Louis, MOMissouri | $601.27 | $348.16 |
| Rest of MissouriMissouri | $561.21 | $332.03 |
| MississippiMississippi | $555.59 | $326.68 |
| MontanaMontana | $622.21 | $356.34 |
| North CarolinaNorth Carolina | $584.94 | $336.88 |
| North DakotaNorth Dakota | $609.16 | $343.29 |
| NebraskaNebraska | $574.80 | $329.41 |
| New HampshireNew Hampshire | $637.47 | $360.70 |
| Northern New JerseyNew Jersey | $704.08 | $395.67 |
| Rest of New JerseyNew Jersey | $671.19 | $380.86 |
| New MexicoNew Mexico | $590.32 | $346.51 |
| NevadaNevada | $619.02 | $352.88 |
| NYC suburbs and Long Island, NYNew York | $734.34 | $418.22 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $675.81 | $384.68 |
| Queens, NYNew York | $722.13 | $407.87 |
| Rest of New YorkNew York | $593.80 | $341.22 |
| OhioOhio | $584.31 | $341.57 |
| OklahomaOklahoma | $570.45 | $333.03 |
| Portland, OROregon | $667.85 | $372.47 |
| Rest of OregonOregon | $613.96 | $349.15 |
| Metropolitan Philadelphia, PAPennsylvania | $647.40 | $370.62 |
| Rest of PennsylvaniaPennsylvania | $585.11 | $341.04 |
| Puerto RicoPuerto Rico | $626.75 | $357.95 |
| Rhode IslandRhode Island | $637.42 | $362.77 |
| South CarolinaSouth Carolina | $585.65 | $339.98 |
| South DakotaSouth Dakota | $607.62 | $341.75 |
| TennesseeTennessee | $572.17 | $330.50 |
| Austin, TXTexas | $645.49 | $364.19 |
| Beaumont, TXTexas | $581.25 | $339.31 |
| Brazoria, TXTexas | $614.76 | $351.28 |
| Dallas, TXTexas | $618.83 | $354.03 |
| Fort Worth, TXTexas | $614.74 | $352.59 |
| Galveston, TXTexas | $616.70 | $352.69 |
| Houston, TXTexas | $628.78 | $364.77 |
| Rest of TexasTexas | $597.77 | $345.46 |
| UtahUtah | $593.72 | $343.80 |
| VirginiaVirginia | $608.33 | $346.98 |
| Virgin Islands, VIUnited States Virgin Islands | $626.75 | $357.95 |
| VermontVermont | $606.99 | $343.77 |
| Rest of WashingtonWashington | $642.32 | $362.36 |
| King County, WAWashington | $725.80 | $399.58 |
| WisconsinWisconsin | $588.60 | $333.89 |
| West VirginiaWest Virginia | $574.35 | $343.31 |
| WyomingWyoming | $616.53 | $350.66 |
68340 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.
$549.78
$740.19
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $721.84 | 1 |
| AL | $557.91 | 1 |
| AR | $549.78 | 1 |
| AZ | $605.50 | 1 |
| CA | $656.85–$823.54 | 29 |
| CO | $647.42 | 1 |
| CT | $663.87 | 1 |
| DC | $711.50 | 1 |
| DE | $615.58 | 1 |
| FL | $614.07–$673.93 | 3 |
| GA | $579.16–$634.19 | 2 |
| GU | $673.01 | 1 |
| HI | $673.01 | 1 |
| IA | $571.72 | 1 |
| ID | $575.58 | 1 |
| IL | $596.54–$654.13 | 4 |
| IN | $578.94 | 1 |
| KS | $569.26 | 1 |
| KY | $571.74 | 1 |
| LA | $570.94–$599.40 | 2 |
| MA | $643.60–$711.49 | 2 |
| MD | $627.33–$711.50 | 3 |
| ME | $578.87–$610.18 | 2 |
| MI | $586.98–$622.04 | 2 |
| MN | $619.45 | 1 |
| MO | $561.21–$601.27 | 3 |
| MS | $555.59 | 1 |
| MT | $622.21 | 1 |
| NC | $584.94 | 1 |
| ND | $609.16 | 1 |
| NE | $574.80 | 1 |
| NH | $637.47 | 1 |
| NJ | $671.19–$704.08 | 2 |
| NM | $590.32 | 1 |
| NV | $619.02 | 1 |
| NY | $593.80–$734.34 | 5 |
| OH | $584.31 | 1 |
| OK | $570.45 | 1 |
| OR | $613.96–$667.85 | 2 |
| PA | $585.11–$647.40 | 2 |
| PR | $626.75 | 1 |
| RI | $637.42 | 1 |
| SC | $585.65 | 1 |
| SD | $607.62 | 1 |
| TN | $572.17 | 1 |
| TX | $581.25–$645.49 | 8 |
| UT | $593.72 | 1 |
| VA | $608.33–$711.50 | 2 |
| VI | $626.75 | 1 |
| VT | $606.99 | 1 |
| WA | $642.32–$725.80 | 2 |
| WI | $588.60 | 1 |
| WV | $574.35 | 1 |
| WY | $616.53 | 1 |
How the 68340 rate is calculated
Each of 68340’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 · 68340
RVUs × geographic indexes × conversion factor
Work4.85
4.85 RVUs× 1.000 GPCI
Practice expense13.12
13.12 RVUs× 1.000 GPCI
Malpractice0.66
0.66 RVUs× 1.000 GPCI
Adjusted RVUs
18.6300
Conversion factor
$33.4009
Medicare rate
$622.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Kansas inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,547
- Code
- 68340
- Physician work
- 4.85
- Practice expense
- 13.12
- Malpractice
- 0.66
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.85 | × 1.000 | 4.8500 |
| Practice expense | 13.12 | × 0.904 | 11.8605 |
| Malpractice | 0.66 | × 0.504 | 0.3326 |
| Total RVUs | 17.0431 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Kansas$569.26
Office: (4.85 × 1 + 13.12 × 0.904 + 0.66 × 0.504) × $33.4009 = $569.26
Facility: (4.85 × 1 + 5.16 × 0.904 + 0.66 × 0.504) × $33.4009 = $328.91
Payment rules and modifiers for 68340
68340 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68340
Adhesion release, eyelid adhesions
| 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 · 68340
Adhesion release, eyelid adhesions
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
68340 without 50 · national office
$622.26
Adhesion release, eyelid adhesions
68340-50 · Bilateral: 150%
$933.39
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 68340 has changed in Kansas
68340 · Office / nonfacility
$569.26
Effective 2026-10-01
The base rate is $40.07 higher than on 2025-10-01, moving from $529.19 to $569.26 (7.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$529.19changed to$569.26
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.97 changed to 4.85
- Practice expense RVU 12.25 changed to 13.12
- Malpractice RVU 0.54 changed to 0.66
- Practice expense GPCI 0.906 changed to 0.904
- Malpractice GPCI 0.540 changed to 0.504
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$553.40changed to$529.19
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 12.59 changed to 12.25
- Malpractice RVU 0.46 changed to 0.54
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$544.37changed to$553.40
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$563.27changed to$544.37
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 12.61 changed to 12.59
- Malpractice RVU 0.43 changed to 0.46
- Practice expense GPCI 0.907 changed to 0.906
- Malpractice GPCI 0.499 changed to 0.540
January 1, 2023
RVU23A
$572.68changed to$563.27
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 12.55 changed to 12.61
- Malpractice RVU 0.40 changed to 0.43
- Practice expense GPCI 0.908 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.499
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$571.57changed to$572.68
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 12.38 changed to 12.55
- Malpractice RVU 0.37 changed to 0.40
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$551.06changed to$571.57
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 11.10 changed to 12.38
- Practice expense GPCI 0.910 changed to 0.908
- Malpractice GPCI 0.536 changed to 0.458
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$538.39changed to$551.06
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 10.70 changed to 11.10
- Malpractice RVU 0.36 changed to 0.37
- Practice expense GPCI 0.911 changed to 0.910
- Malpractice GPCI 0.615 changed to 0.536
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$522.06changed to$538.39
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 10.22 changed to 10.70
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$513.76changed to$522.06
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 10.05 changed to 10.22
- Practice expense GPCI 0.907 changed to 0.911
- Malpractice GPCI 0.639 changed to 0.615
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$511.32changed to$513.76
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 10.04 changed to 10.05
- Malpractice RVU 0.37 changed to 0.36
- Practice expense GPCI 0.903 changed to 0.907
- Malpractice GPCI 0.662 changed to 0.639
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$512.61changed to$511.32
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 10.03 changed to 10.04
- Malpractice RVU 0.36 changed to 0.37
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$510.06changed to$512.61
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$527.33changed to$510.06
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 9.99 changed to 10.03
- Malpractice RVU 0.95 changed to 0.36
- Practice expense GPCI 0.899 changed to 0.903
- Malpractice GPCI 0.810 changed to 0.662
Held through RVU15B.
January 1, 2014
RVU14A
$535.91changed to$527.33
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 11.00 changed to 9.99
- Malpractice RVU 0.99 changed to 0.95
- Practice expense GPCI 0.894 changed to 0.899
- Malpractice GPCI 0.957 changed to 0.810
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $535.91
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $569.26 | $328.91 | RVU26D |
| 2026-07-01 | $569.26 | $328.91 | RVU26C |
| 2026-04-01 | $569.26 | $328.91 | RVU26B |
| 2026-01-01 | $569.26 | $328.91 | RVU26A |
| 2025-10-01 | $529.19 | $355.70 | RVU25D |
| 2025-07-01 | $529.19 | $355.70 | RVU25C |
| 2025-04-01 | $529.19 | $355.70 | RVU25B |
| 2025-01-01 | $529.19 | $355.70 | RVU25A |
| 2024-10-01 | $553.40 | $367.02 | RVU24D |
| 2024-07-01 | $553.40 | $367.02 | RVU24C |
| 2024-04-01 | $553.40 | $367.02 | RVU24B |
| 2024-03-09 | $553.40 | $367.02 | RVU24AR |
| 2024-01-01 | $544.37 | $361.03 | RVU24A |
| 2023-10-01 | $563.27 | $369.94 | RVU23D |
| 2023-07-01 | $563.27 | $369.94 | RVU23C |
| 2023-04-01 | $563.27 | $369.94 | RVU23B |
| 2023-01-01 | $563.27 | $369.94 | RVU23A |
| 2022-10-01 | $572.68 | $371.27 | RVU22D |
| 2022-07-01 | $572.68 | $371.27 | RVU22C |
| 2022-04-01 | $572.68 | $371.27 | RVU22B |
| 2022-01-01 | $572.68 | $371.27 | RVU22A |
| 2021-10-01 | $571.57 | $373.55 | RVU21D |
| 2021-07-01 | $571.57 | $373.55 | RVU21C |
| 2021-04-01 | $571.57 | $373.55 | RVU21B |
| 2021-01-01 | $571.57 | $373.55 | RVU21A |
| 2020-10-01 | $551.06 | $380.62 | RVU20D |
| 2020-07-01 | $551.06 | $380.62 | RVU20C |
| 2020-04-01 | $551.06 | $380.62 | RVU20B |
| 2020-01-01 | $551.06 | $380.62 | RVU20A |
| 2019-10-01 | $538.39 | $384.41 | RVU19D |
| 2019-07-01 | $538.39 | $384.41 | RVU19C |
| 2019-04-01 | $538.39 | $384.41 | RVU19B |
| 2019-01-01 | $538.39 | $384.41 | RVU19A |
| 2018-10-01 | $522.06 | $385.63 | RVU18D |
| 2018-07-01 | $522.06 | $385.63 | RVU18C |
| 2018-04-01 | $522.06 | $385.63 | RVU18B |
| 2018-01-01 | $522.06 | $385.63 | RVU18AR1 |
| 2017-10-01 | $513.76 | $381.60 | RVU17D |
| 2017-07-01 | $513.76 | $381.60 | RVU17C |
| 2017-04-01 | $513.76 | $381.60 | RVU17B |
| 2017-01-01 | $513.76 | $381.60 | RVU17A |
| 2016-10-01 | $511.32 | $380.06 | RVU16D |
| 2016-07-01 | $511.32 | $380.06 | RVU16C |
| 2016-04-01 | $511.32 | $380.06 | RVU16B |
| 2016-01-01 | $511.32 | $380.06 | RVU16A |
| 2015-10-01 | $512.61 | $380.54 | RVU15D |
| 2015-07-01 | $512.61 | $380.54 | RVU15C |
| 2015-04-01 | $510.06 | $378.65 | RVU15B |
| 2015-01-01 | $510.06 | $378.65 | RVU15A |
| 2014-10-01 | $527.33 | $397.87 | RVU14D |
| 2014-07-01 | $527.33 | $397.87 | RVU14C |
| 2014-04-01 | $527.33 | $397.87 | RVU14B |
| 2014-01-01 | $527.33 | $397.87 | RVU14A |
| 2013-10-01 | $535.91 | $399.34 | RVU13D |
| 2013-07-01 | $535.91 | $399.34 | RVU13C |
| 2013-04-01 | $535.91 | $399.34 | RVU13B |
| 2013-01-01 | $535.91 | $399.34 | RVU13AR |
Where the Kansas rate applies
Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.
- Abbyville
- Abilene
- Ada
- Admire
- Agenda
- Agra
- Albert
- Alden
68340 billing questions
When should this code be chosen instead of an eyelid-lining reconstruction code?
Use this code when the operative objective is dividing an adhesion that binds eyelid structures. A lining reconstruction code describes work to revise or rebuild the eyelid lining.
What should the operative note document?
Document the adhesion's location and extent, which eyelid or lids are involved, the resulting functional or anatomic problem, and how the adhesion was released.
Does the code have a postoperative global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
CMS identifies the procedure as bilateral when modifier 50 is used and pays it at 150%. The operative record should support treatment of both sides.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The standard multiple procedure reduction applies: the highest-valued procedure is paid in full, and 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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