CPT code 68360: Conjunctivoplasty, cul-de-sac reconstruction2026 Medicare rate & RVUs in Delaware
An ophthalmic surgeon uses this code for surgical reconstruction of the conjunctival cul-de-sac, often when scarring has contracted the eyelid lining.
In Delaware, Medicare pays $541.55 for 68360 in the office and $352.46 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 68360 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 68360 covers
CPT 68360 describes surgical reconstruction of the conjunctival cul-de-sac, the pocket formed by the eyelid lining and the eye surface. Ophthalmologists may perform it to restore the fornix when scarring has shortened or distorted the lining, including after injury, inflammation, or prior surgery. These procedures are generally performed in a surgical facility rather than an office.
Select the code from the operative work documented: the record should identify the affected side, the cul-de-sac or fornix addressed, the extent of reconstruction, and the technique used. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery services are not paid; 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 Delaware compares for 68360
Across 109 of 109 payment localities, the office rate for 68360 runs from $488.53 in Arkansas to $719.97 in San Benito County, CA. Delaware pays $541.55. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Delaware · this page$541.55
- Los Angeles, CA · California$615.60+$74.05
- Washington, DC area · District of Columbia$621.96+$80.41
- Miami, FL · Florida$581.82+$40.27
- Chicago, IL · Illinois$566.74+$25.19
- Manhattan, NY · New York$624.13+$82.58
- Alaska · Alaska$648.32+$106.77
Other areas in Delaware first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $495.05 | $327.58 |
| ArkansasArkansas | $488.53 | $324.13 |
| ArizonaArizona | $533.21 | $347.75 |
| Bakersfield, CACalifornia | $579.43 | $369.67 |
| Chico, CACalifornia | $578.12 | $368.36 |
| El Centro, CACalifornia | $578.18 | $368.42 |
| Fresno, CACalifornia | $578.12 | $368.36 |
| Hanford, CACalifornia | $578.12 | $368.36 |
| Madera, CACalifornia | $578.12 | $368.36 |
| Merced, CACalifornia | $578.12 | $368.36 |
| Modesto, CACalifornia | $578.12 | $368.36 |
| Napa, CACalifornia | $666.46 | $414.21 |
| Oxnard, CACalifornia | $612.50 | $386.28 |
| Redding, CACalifornia | $578.12 | $368.36 |
| Rest of CaliforniaCalifornia | $578.12 | $368.36 |
| Riverside, CACalifornia | $582.52 | $372.76 |
| Sacramento, CACalifornia | $605.75 | $383.17 |
| Salinas, CACalifornia | $603.45 | $381.63 |
| San Diego, CACalifornia | $616.86 | $387.96 |
| Marin County, CACalifornia | $704.75 | $434.89 |
| San Francisco, CACalifornia | $704.29 | $434.44 |
| San Benito County, CACalifornia | $719.97 | $443.99 |
| Santa Clara County, CACalifornia | $718.11 | $442.13 |
| San Luis Obispo, CACalifornia | $593.80 | $375.81 |
| Santa Cruz, CACalifornia | $622.19 | $389.66 |
| Santa Maria, CACalifornia | $605.50 | $382.34 |
| Santa Rosa, CACalifornia | $628.45 | $393.43 |
| Stockton, CACalifornia | $578.12 | $368.36 |
| Vallejo, CACalifornia | $665.80 | $413.55 |
| Visalia, CACalifornia | $578.12 | $368.36 |
| Yuba City, CACalifornia | $578.12 | $368.36 |
| ColoradoColorado | $568.88 | $365.24 |
| ConnecticutConnecticut | $580.70 | $374.57 |
| Fort Lauderdale, FLFlorida | $561.98 | $368.10 |
| Rest of FloridaFlorida | $537.11 | $354.14 |
| Atlanta, GAGeorgia | $555.46 | $361.02 |
| Rest of GeorgiaGeorgia | $509.61 | $338.89 |
| Hawaii, Guam, HIHawaii | $590.78 | $373.18 |
| IowaIowa | $507.38 | $332.26 |
| IdahoIdaho | $510.22 | $334.14 |
| East St. Louis, ILIllinois | $530.81 | $354.73 |
| Rest of IllinoisIllinois | $522.23 | $347.49 |
| Suburban Chicago, ILIllinois | $567.78 | $371.22 |
| IndianaIndiana | $512.95 | $335.53 |
| KansasKansas | $504.80 | $331.78 |
| KentuckyKentucky | $504.82 | $334.67 |
| New Orleans, LALouisiana | $526.74 | $346.64 |
| Rest of LouisianaLouisiana | $503.93 | $334.56 |
| Metropolitan Boston, MAMassachusetts | $622.63 | $394.11 |
| Rest of MassachusettsMassachusetts | $565.75 | $364.22 |
| Baltimore area, MDMaryland | $578.92 | $373.57 |
| Rest of MarylandMaryland | $551.40 | $357.72 |
| Rest of MaineMaine | $512.21 | $336.13 |
| Southern Maine, MEMaine | $538.23 | $348.56 |
| Detroit, MIMichigan | $542.84 | $358.15 |
| Rest of MichiganMichigan | $516.43 | $341.69 |
| MinnesotaMinnesota | $547.61 | $350.67 |
| Metropolitan Kansas City, MOMissouri | $523.88 | $344.17 |
| Metropolitan St. Louis, MOMissouri | $528.96 | $346.76 |
| Rest of MissouriMissouri | $495.76 | $330.78 |
| MississippiMississippi | $492.25 | $327.47 |
| MontanaMontana | $546.41 | $355.02 |
| North CarolinaNorth Carolina | $517.18 | $338.61 |
| North DakotaNorth Dakota | $538.50 | $347.12 |
| NebraskaNebraska | $510.04 | $333.39 |
| New HampshireNew Hampshire | $559.72 | $360.49 |
| Northern New JerseyNew Jersey | $616.31 | $394.30 |
| Rest of New JerseyNew Jersey | $588.02 | $379.03 |
| New MexicoNew Mexico | $518.85 | $343.35 |
| NevadaNevada | $544.57 | $352.99 |
| NYC suburbs and Long Island, NYNew York | $637.60 | $410.04 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $591.47 | $381.90 |
| Queens, NYNew York | $629.50 | $403.28 |
| Rest of New YorkNew York | $524.23 | $342.42 |
| OhioOhio | $514.81 | $340.08 |
| OklahomaOklahoma | $504.43 | $333.52 |
| Portland, OROregon | $586.20 | $373.57 |
| Rest of OregonOregon | $541.01 | $350.39 |
| Metropolitan Philadelphia, PAPennsylvania | $567.00 | $367.77 |
| Rest of PennsylvaniaPennsylvania | $515.80 | $340.10 |
| Puerto RicoPuerto Rico | $550.25 | $356.76 |
| Rhode IslandRhode Island | $560.23 | $362.53 |
| South CarolinaSouth Carolina | $516.71 | $339.87 |
| South DakotaSouth Dakota | $537.57 | $346.18 |
| TennesseeTennessee | $507.06 | $333.09 |
| Austin, TXTexas | $566.41 | $363.92 |
| Beaumont, TXTexas | $512.66 | $338.50 |
| Brazoria, TXTexas | $541.56 | $351.90 |
| Dallas, TXTexas | $544.60 | $353.98 |
| Fort Worth, TXTexas | $541.12 | $352.42 |
| Galveston, TXTexas | $542.93 | $352.89 |
| Houston, TXTexas | $550.26 | $360.21 |
| Rest of TexasTexas | $526.54 | $344.91 |
| UtahUtah | $523.19 | $343.29 |
| VirginiaVirginia | $536.31 | $348.18 |
| Virgin Islands, VIUnited States Virgin Islands | $550.25 | $356.76 |
| VermontVermont | $536.19 | $346.72 |
| Rest of WashingtonWashington | $564.77 | $363.23 |
| King County, WAWashington | $635.21 | $400.37 |
| WisconsinWisconsin | $521.87 | $338.53 |
| West VirginiaWest Virginia | $504.42 | $338.10 |
| WyomingWyoming | $542.97 | $351.58 |
68360 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.
$488.53
$649.05
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 | $648.32 | 1 |
| AL | $495.05 | 1 |
| AR | $488.53 | 1 |
| AZ | $533.21 | 1 |
| CA | $578.12–$719.97 | 29 |
| CO | $568.88 | 1 |
| CT | $580.70 | 1 |
| DC | $621.96 | 1 |
| DE | $541.55 | 1 |
| FL | $537.11–$581.82 | 3 |
| GA | $509.61–$555.46 | 2 |
| GU | $590.78 | 1 |
| HI | $590.78 | 1 |
| IA | $507.38 | 1 |
| ID | $510.22 | 1 |
| IL | $522.23–$567.78 | 4 |
| IN | $512.95 | 1 |
| KS | $504.80 | 1 |
| KY | $504.82 | 1 |
| LA | $503.93–$526.74 | 2 |
| MA | $565.75–$622.63 | 2 |
| MD | $551.40–$621.96 | 3 |
| ME | $512.21–$538.23 | 2 |
| MI | $516.43–$542.84 | 2 |
| MN | $547.61 | 1 |
| MO | $495.76–$528.96 | 3 |
| MS | $492.25 | 1 |
| MT | $546.41 | 1 |
| NC | $517.18 | 1 |
| ND | $538.50 | 1 |
| NE | $510.04 | 1 |
| NH | $559.72 | 1 |
| NJ | $588.02–$616.31 | 2 |
| NM | $518.85 | 1 |
| NV | $544.57 | 1 |
| NY | $524.23–$637.60 | 5 |
| OH | $514.81 | 1 |
| OK | $504.43 | 1 |
| OR | $541.01–$586.20 | 2 |
| PA | $515.80–$567.00 | 2 |
| PR | $550.25 | 1 |
| RI | $560.23 | 1 |
| SC | $516.71 | 1 |
| SD | $537.57 | 1 |
| TN | $507.06 | 1 |
| TX | $512.66–$566.41 | 8 |
| UT | $523.19 | 1 |
| VA | $536.31–$621.96 | 2 |
| VI | $550.25 | 1 |
| VT | $536.19 | 1 |
| WA | $564.77–$635.21 | 2 |
| WI | $521.87 | 1 |
| WV | $504.42 | 1 |
| WY | $542.97 | 1 |
How the 68360 rate is calculated
Each of 68360’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 · 68360
RVUs × geographic indexes × conversion factor
Work5.04
5.04 RVUs× 1.000 GPCI
Practice expense10.92
10.92 RVUs× 1.000 GPCI
Malpractice0.40
0.40 RVUs× 1.000 GPCI
Adjusted RVUs
16.3600
Conversion factor
$33.4009
Medicare rate
$546.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Delaware inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,548
- Code
- 68360
- Physician work
- 5.04
- Practice expense
- 10.92
- Malpractice
- 0.40
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.04 | × 1.005 | 5.0652 |
| Practice expense | 10.92 | × 0.988 | 10.7890 |
| Malpractice | 0.40 | × 0.899 | 0.3596 |
| Total RVUs | 16.2138 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Delaware$541.55
Office: (5.04 × 1.005 + 10.92 × 0.988 + 0.4 × 0.899) × $33.4009 = $541.55
Facility: (5.04 × 1.005 + 5.19 × 0.988 + 0.4 × 0.899) × $33.4009 = $352.46
Payment rules and modifiers for 68360
68360 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68360
Conjunctivoplasty, cul-de-sac 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) | 1 | Not paid (statutory restriction). |
| 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 · 68360
Conjunctivoplasty, cul-de-sac 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
68360 without 50 · national office
$546.44
Conjunctivoplasty, cul-de-sac reconstruction
68360-50 · Bilateral: 150%
$819.66
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 68360 has changed in Delaware
68360 · Office / nonfacility
$541.55
Effective 2026-10-01
The base rate is $24.58 higher than on 2025-10-01, moving from $516.97 to $541.55 (4.8%).
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
$516.97changed to$541.55
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 5.17 changed to 5.04
- Practice expense RVU 10.47 changed to 10.92
- Work GPCI 1.009 changed to 1.005
- Practice expense GPCI 0.992 changed to 0.988
- Malpractice GPCI 0.949 changed to 0.899
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$537.96changed to$516.97
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 10.65 changed to 10.47
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$529.18changed to$537.96
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$549.83changed to$529.18
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 10.57 changed to 10.65
- Work GPCI 1.007 changed to 1.009
- Practice expense GPCI 1.007 changed to 0.992
- Malpractice GPCI 0.938 changed to 0.949
January 1, 2023
RVU23A
$561.88changed to$549.83
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 10.44 changed to 10.57
- Work GPCI 1.005 changed to 1.007
- Practice expense GPCI 1.022 changed to 1.007
- Malpractice GPCI 0.927 changed to 0.938
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$568.35changed to$561.88
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 10.50 changed to 10.44
- Malpractice RVU 0.39 changed to 0.40
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$559.52changed to$568.35
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 9.70 changed to 10.50
- Work GPCI 1.006 changed to 1.005
- Practice expense GPCI 1.021 changed to 1.022
- Malpractice GPCI 1.023 changed to 0.927
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$561.22changed to$559.52
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 9.69 changed to 9.70
- Malpractice RVU 0.44 changed to 0.39
- Work GPCI 1.007 changed to 1.006
- Practice expense GPCI 1.019 changed to 1.021
- Malpractice GPCI 1.119 changed to 1.023
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$554.49changed to$561.22
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 9.60 changed to 9.69
- Malpractice RVU 0.37 changed to 0.44
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$551.20changed to$554.49
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 9.46 changed to 9.60
- Malpractice RVU 0.40 changed to 0.37
- Work GPCI 1.010 changed to 1.007
- Practice expense GPCI 1.025 changed to 1.019
- Malpractice GPCI 1.101 changed to 1.119
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$551.70changed to$551.20
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 9.44 changed to 9.46
- Malpractice RVU 0.41 changed to 0.40
- Work GPCI 1.012 changed to 1.010
- Practice expense GPCI 1.031 changed to 1.025
- Malpractice GPCI 1.083 changed to 1.101
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$551.39changed to$551.70
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 9.42 changed to 9.44
- Malpractice RVU 0.37 changed to 0.41
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$548.65changed to$551.39
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$568.15changed to$548.65
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 9.41 changed to 9.42
- Malpractice RVU 0.98 changed to 0.37
- Practice expense GPCI 1.038 changed to 1.031
- Malpractice GPCI 0.878 changed to 1.083
Held through RVU15B.
January 1, 2014
RVU14A
$568.25changed to$568.15
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 10.33 changed to 9.41
- Malpractice RVU 1.02 changed to 0.98
- Practice expense GPCI 1.044 changed to 1.038
- Malpractice GPCI 0.672 changed to 0.878
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $568.25
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $541.55 | $352.46 | RVU26D |
| 2026-07-01 | $541.55 | $352.46 | RVU26C |
| 2026-04-01 | $541.55 | $352.46 | RVU26B |
| 2026-01-01 | $541.55 | $352.46 | RVU26A |
| 2025-10-01 | $516.97 | $394.72 | RVU25D |
| 2025-07-01 | $516.97 | $394.72 | RVU25C |
| 2025-04-01 | $516.97 | $394.72 | RVU25B |
| 2025-01-01 | $516.97 | $394.72 | RVU25A |
| 2024-10-01 | $537.96 | $405.54 | RVU24D |
| 2024-07-01 | $537.96 | $405.54 | RVU24C |
| 2024-04-01 | $537.96 | $405.54 | RVU24B |
| 2024-03-09 | $537.96 | $405.54 | RVU24AR |
| 2024-01-01 | $529.18 | $398.92 | RVU24A |
| 2023-10-01 | $549.83 | $410.61 | RVU23D |
| 2023-07-01 | $549.83 | $410.61 | RVU23C |
| 2023-04-01 | $549.83 | $410.61 | RVU23B |
| 2023-01-01 | $549.83 | $410.61 | RVU23A |
| 2022-10-01 | $561.88 | $414.75 | RVU22D |
| 2022-07-01 | $561.88 | $414.75 | RVU22C |
| 2022-04-01 | $561.88 | $414.75 | RVU22B |
| 2022-01-01 | $561.88 | $414.75 | RVU22A |
| 2021-10-01 | $568.35 | $416.79 | RVU21D |
| 2021-07-01 | $568.35 | $416.79 | RVU21C |
| 2021-04-01 | $568.35 | $416.79 | RVU21B |
| 2021-01-01 | $568.35 | $416.79 | RVU21A |
| 2020-10-01 | $559.52 | $424.29 | RVU20D |
| 2020-07-01 | $559.52 | $424.29 | RVU20C |
| 2020-04-01 | $559.52 | $424.29 | RVU20B |
| 2020-01-01 | $559.52 | $424.29 | RVU20A |
| 2019-10-01 | $561.22 | $430.12 | RVU19D |
| 2019-07-01 | $561.22 | $430.12 | RVU19C |
| 2019-04-01 | $561.22 | $430.12 | RVU19B |
| 2019-01-01 | $561.22 | $430.12 | RVU19A |
| 2018-10-01 | $554.49 | $429.76 | RVU18D |
| 2018-07-01 | $554.49 | $429.76 | RVU18C |
| 2018-04-01 | $554.49 | $429.76 | RVU18B |
| 2018-01-01 | $554.49 | $429.76 | RVU18AR1 |
| 2017-10-01 | $551.20 | $428.34 | RVU17D |
| 2017-07-01 | $551.20 | $428.34 | RVU17C |
| 2017-04-01 | $551.20 | $428.34 | RVU17B |
| 2017-01-01 | $551.20 | $428.34 | RVU17A |
| 2016-10-01 | $551.70 | $428.77 | RVU16D |
| 2016-07-01 | $551.70 | $428.77 | RVU16C |
| 2016-04-01 | $551.70 | $428.77 | RVU16B |
| 2016-01-01 | $551.70 | $428.77 | RVU16A |
| 2015-10-01 | $551.39 | $428.02 | RVU15D |
| 2015-07-01 | $551.39 | $428.02 | RVU15C |
| 2015-04-01 | $548.65 | $425.89 | RVU15B |
| 2015-01-01 | $548.65 | $425.89 | RVU15A |
| 2014-10-01 | $568.15 | $445.07 | RVU14D |
| 2014-07-01 | $568.15 | $445.07 | RVU14C |
| 2014-04-01 | $568.15 | $445.07 | RVU14B |
| 2014-01-01 | $568.15 | $445.07 | RVU14A |
| 2013-10-01 | $568.25 | $437.54 | RVU13D |
| 2013-07-01 | $568.25 | $437.54 | RVU13C |
| 2013-04-01 | $568.25 | $437.54 | RVU13B |
| 2013-01-01 | $568.25 | $437.54 | RVU13AR |
Where the Delaware rate applies
Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.
- Arden
- Ardencroft
- Ardentown
- Bear
- Bellefonte
- Bethany Beach
- Bethel
- Blades
68360 billing questions
When is 68360 appropriate instead of 68340?
Use 68360 for reconstruction of the conjunctival cul-de-sac. Code 68340 describes severing adhesions; it is the more fitting choice when the documented service is limited to releasing conjunctival adhesions.
What documentation supports 68360?
Document the side and specific cul-de-sac or fornix treated, the scarring or distortion, and the reconstructive work performed. The operative report should make clear how the work restores the eyelid lining.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The routine related follow-up is not separately represented by another service code.
How is 68360 reported when both sides are reconstructed?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed 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
Fee sheets
Put 68360 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet