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CPT code 68360: Conjunctivoplasty, cul-de-sac reconstruction2026 Medicare rate & RVUs in Wisconsin

An ophthalmic surgeon uses this code for surgical reconstruction of the conjunctival cul-de-sac, often when scarring has contracted the eyelid lining.

CMS RVU26DEffective Oct 1, 2026One payment locality55 Medicare services in 2024

In Wisconsin, Medicare pays $521.87 for 68360 in the office and $338.53 when it’s performed in a hospital or facility.

$521.87Office (non-facility)
$338.53Hospital or facility
−4.5%vs the national office rate ($546.44)

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.

We’ll open 68360 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Wisconsin
  2. What 68360 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Wisconsin 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. Wisconsin pays $521.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

68360 in Wisconsin vs other payment areas
  1. Wisconsin · this page$521.87
  2. Los Angeles, CA · California$615.60+$93.73
  3. Washington, DC area · District of Columbia$621.96+$100.09
  4. Miami, FL · Florida$581.82+$59.95
  5. Chicago, IL · Illinois$566.74+$44.87
  6. Manhattan, NY · New York$624.13+$102.26
  7. Alaska · Alaska$648.32+$126.45

Other areas in Wisconsin first, then benchmark localities. Bars start at $0.

Every other payment area

68360 in every other Medicare payment locality
Payment localityOfficeFacility
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

68360 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
68360 office rate range by state
State / territoryOffice rate rangeLocalities
AK$648.321
AL$495.051
AR$488.531
AZ$533.211
CA$578.12–$719.9729
CO$568.881
CT$580.701
DC$621.961
DE$541.551
FL$537.11–$581.823
GA$509.61–$555.462
GU$590.781
HI$590.781
IA$507.381
ID$510.221
IL$522.23–$567.784
IN$512.951
KS$504.801
KY$504.821
LA$503.93–$526.742
MA$565.75–$622.632
MD$551.40–$621.963
ME$512.21–$538.232
MI$516.43–$542.842
MN$547.611
MO$495.76–$528.963
MS$492.251
MT$546.411
NC$517.181
ND$538.501
NE$510.041
NH$559.721
NJ$588.02–$616.312
NM$518.851
NV$544.571
NY$524.23–$637.605
OH$514.811
OK$504.431
OR$541.01–$586.202
PA$515.80–$567.002
PR$550.251
RI$560.231
SC$516.711
SD$537.571
TN$507.061
TX$512.66–$566.418
UT$523.191
VA$536.31–$621.962
VI$550.251
VT$536.191
WA$564.77–$635.212
WI$521.871
WV$504.421
WY$542.971

See 68360 in every payment locality

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

Office or facility?

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 Wisconsin 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

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office calculation for 68360 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work5.04× 1.0005.0400
Practice expense10.92× 0.95810.4614
Malpractice0.40× 0.3080.1232
Total RVUs15.6246
Conversion factor× 33.4009

Office rate, Wisconsin$521.87

Office: (5.04 × 1 + 10.92 × 0.958 + 0.4 × 0.308) × $33.4009 = $521.87

Facility: (5.04 × 1 + 5.19 × 0.958 + 0.4 × 0.308) × $33.4009 = $338.53

Open 68360 in the RVU calculator

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

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)1Not paid (statutory restriction).
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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 68360

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

Codes related to 68360
CodeHow it relatesOffice range, Wisconsin
Same family
68330Symblepharon repair, without graftRelated conjunctival lining revision code; distinguish the documented operative service.$596.08
68320Conjunctivoplasty, graft or extensive rearrangementRelated conjunctivoplasty code involving a graft or extensive rearrangement.$713.80
68362Fornix reconstruction, with mucous membrane graftRelated code for reconstruction of the conjunctival cul-de-sac; compare the operative technique.No office rate
Used instead
68340Adhesion release, eyelid adhesionsUsed when the service is severing conjunctival and eyelid adhesions rather than cul-de-sac reconstruction.$588.60

How 68360 has changed in Wisconsin

68360 · Office / nonfacility

$521.87

Effective 2026-10-01

The base rate is $26.25 higher than on 2025-10-01, moving from $495.62 to $521.87 (5.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $495.62changed to$521.87

    • 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
    • Practice expense GPCI 0.957 changed to 0.958
    • Malpractice GPCI 0.331 changed to 0.308

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $515.77changed to$495.62

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.65 changed to 10.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $507.35changed to$515.77

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $519.73changed to$507.35

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.57 changed to 10.65
    • Practice expense GPCI 0.950 changed to 0.957
    • Malpractice GPCI 0.314 changed to 0.331

  5. January 1, 2023

    RVU23A

    $523.35changed to$519.73

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.44 changed to 10.57
    • Practice expense GPCI 0.942 changed to 0.950
    • Malpractice GPCI 0.296 changed to 0.314

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $529.55changed to$523.35

    • 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.

  7. January 1, 2021

    RVU21A

    $523.33changed to$529.55

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.70 changed to 10.50
    • Practice expense GPCI 0.949 changed to 0.942
    • Malpractice GPCI 0.322 changed to 0.296

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $526.03changed to$523.33

    • 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
    • Practice expense GPCI 0.957 changed to 0.949
    • Malpractice GPCI 0.347 changed to 0.322

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $521.48changed to$526.03

    • 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.

  10. January 1, 2018

    RVU18AR1

    $516.67changed to$521.48

    • 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
    • Practice expense GPCI 0.956 changed to 0.957
    • Malpractice GPCI 0.457 changed to 0.347

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $516.20changed to$516.67

    • 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
    • Practice expense GPCI 0.955 changed to 0.956
    • Malpractice GPCI 0.566 changed to 0.457

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $516.56changed to$516.20

    • 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.

  13. July 1, 2015

    RVU15C

    $513.99changed to$516.56

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $527.69changed to$513.99

    • 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 0.958 changed to 0.955
    • Malpractice GPCI 0.557 changed to 0.566

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $532.28changed to$527.69

    • 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 0.960 changed to 0.958
    • Malpractice GPCI 0.547 changed to 0.557

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$532.28

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$521.87$338.53RVU26D
2026-07-01$521.87$338.53RVU26C
2026-04-01$521.87$338.53RVU26B
2026-01-01$521.87$338.53RVU26A
2025-10-01$495.62$377.68RVU25D
2025-07-01$495.62$377.68RVU25C
2025-04-01$495.62$377.68RVU25B
2025-01-01$495.62$377.68RVU25A
2024-10-01$515.77$388.03RVU24D
2024-07-01$515.77$388.03RVU24C
2024-04-01$515.77$388.03RVU24B
2024-03-09$515.77$388.03RVU24AR
2024-01-01$507.35$381.70RVU24A
2023-10-01$519.73$388.38RVU23D
2023-07-01$519.73$388.38RVU23C
2023-04-01$519.73$388.38RVU23B
2023-01-01$519.73$388.38RVU23A
2022-10-01$523.35$387.73RVU22D
2022-07-01$523.35$387.73RVU22C
2022-04-01$523.35$387.73RVU22B
2022-01-01$523.35$387.73RVU22A
2021-10-01$529.55$389.86RVU21D
2021-07-01$529.55$389.86RVU21C
2021-04-01$529.55$389.86RVU21B
2021-01-01$529.55$389.86RVU21A
2020-10-01$523.33$397.64RVU20D
2020-07-01$523.33$397.64RVU20C
2020-04-01$523.33$397.64RVU20B
2020-01-01$523.33$397.64RVU20A
2019-10-01$526.03$402.90RVU19D
2019-07-01$526.03$402.90RVU19C
2019-04-01$526.03$402.90RVU19B
2019-01-01$526.03$402.90RVU19A
2018-10-01$521.48$404.34RVU18D
2018-07-01$521.48$404.34RVU18C
2018-04-01$521.48$404.34RVU18B
2018-01-01$521.48$404.34RVU18AR1
2017-10-01$516.67$402.08RVU17D
2017-07-01$516.67$402.08RVU17C
2017-04-01$516.67$402.08RVU17B
2017-01-01$516.67$402.08RVU17A
2016-10-01$516.20$402.34RVU16D
2016-07-01$516.20$402.34RVU16C
2016-04-01$516.20$402.34RVU16B
2016-01-01$516.20$402.34RVU16A
2015-10-01$516.56$402.29RVU15D
2015-07-01$516.56$402.29RVU15C
2015-04-01$513.99$400.29RVU15B
2015-01-01$513.99$400.29RVU15A
2014-10-01$527.69$414.10RVU14D
2014-07-01$527.69$414.10RVU14C
2014-04-01$527.69$414.10RVU14B
2014-01-01$527.69$414.10RVU14A
2013-10-01$532.28$412.08RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 68360 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Wisconsin

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
RVUs for 68360PPRRVU2026_Oct_nonQPP.csv, line 7,548 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)

Open CMS sourceHow we calculate rates

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