CPT code 68362: Fornix reconstruction, with mucous membrane graft2026 Medicare rate & RVUs

Medicare pays $559.47 for 68362 nationally in a facility.

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

What 68362 covers

An ophthalmic surgeon, often an oculoplastic specialist, uses this procedure to restore the conjunctival fornix—the pocket between the eyelid and the eye—when scarring has shortened or distorted it. The operation involves releasing or addressing scarred tissue and using a mucous membrane graft to rebuild the lining and help restore fornix depth. It is generally performed in an operating room for cicatricial changes such as severe conjunctival scarring or symblepharon that compromise the fornix.

Report the code when the service includes fornix reconstruction with a mucous membrane graft, rather than a reconstruction without graft or a more limited adhesion-release procedure. The operative report should identify the affected eye, the scarring and loss of fornix depth, the reconstruction performed, and the graft used. Medicare applies a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is 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.

Where 68362 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

68362 rates by state

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

How the 68362 rate is calculated

Each of 68362’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 68362

68362 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

68362 compared with similar codes

How to choose

68360ConjunctivoplastyCul-de-sac reconstruction

This code involves fornix reconstruction with a mucous membrane graft. Code 68360 describes the related reconstruction without a graft.

68335Symblepharon repairWith graft

Code 68335 is for symblepharon repair with graft. Choose 68362 when the documented operation reconstructs the conjunctival fornix with a mucous membrane graft.

68340Adhesion releaseEyelid adhesions

Code 68340 describes severing adhesions between the conjunctiva and eyelid. It does not describe graft-based reconstruction of the fornix.

Codes related to 68362

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

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