CPT code 68320: Conjunctivoplasty2026 Medicare rate & RVUs

Medicare pays $747.18 for 68320 nationally in the office and $468.28 in a hospital or facility. Local office rates run $666.44–$990.25.

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

What 68320 covers

An ophthalmic surgeon uses this code to repair or reconstruct the conjunctival lining when a graft of conjunctival tissue or extensive rearrangement is needed. The work may address scarred or contracted tissue that interferes with the lining’s function, including changes associated with adhesions or ocular surface injury. It is performed in an ophthalmic surgical setting by a surgeon managing the affected eye and surrounding tissues.

Choose the code based on the documented reconstruction method and extent, distinguishing graft-based or extensive rearrangement from a procedure without grafting or a different graft type. The operative report should identify the affected area, the tissue used or rearranged, and the reconstructive work performed. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%. When multiple procedures are performed in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons require 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 68320 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

68320 rates by state

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

How the 68320 rate is calculated

Each of 68320’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 68320

68320 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

68320 compared with similar codes

How to choose

68330Symblepharon repair

Use 68320 for conjunctival grafting or extensive tissue rearrangement; 68330 describes conjunctivoplasty without a graft.

68325Conjunctivoplasty

Use 68325 when the reconstruction uses a buccal mucous membrane graft. This code covers a conjunctival graft or extensive rearrangement.

68340Adhesion release

Use 68340 for separating eyelid adhesions. Choose 68320 when the documented service reconstructs the conjunctival lining with a graft or extensive rearrangement.

Codes related to 68320

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