$578.12
This code involves fornix reconstruction with a mucous membrane graft. Code 68360 describes the related reconstruction without a graft.
On this page
CMS RVU26D · Effective 2026-10-01
68362 in Madera
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$578.69
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Ophthalmic surgery
About 68362: Conjunctival fornix reconstruction with graft
Reconstructs a shortened or scarred conjunctival fornix using a mucous membrane graft, typically when scarring prevents adequate depth between the eyelid and globe.
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.
CMS billing rules for 68362
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.39 · 50%
- Practice expense (office) RVU7.70 · 46%
- Malpractice RVU0.66 · 4%
182
Medicare services in 2024 · #4413 by national volume
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.
68362 compared with similar codes
Office rates for Madera, from the same CMS release.
No office rate
Code 68335 is for symblepharon repair with graft. Choose 68362 when the documented operation reconstructs the conjunctival fornix with a mucous membrane graft.
$656.85
Code 68340 describes severing adhesions between the conjunctiva and eyelid. It does not describe graft-based reconstruction of the fornix.
The same code, a different location
How does Madera compare?
68362 across payment areas
Same release and payment basis · bars start at $0
Madera · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Modesto
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Napa
California · 68362
Office
Unavailable
Facility
$648.06
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 68362
Office
Unavailable
Facility
$605.81
No comparable office rate is available.
Redding
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Rest Of California
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 68362
Office
Unavailable
Facility
$585.96
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 68362
Office
Unavailable
Facility
$601.25
No comparable office rate is available.
Salinas
California · 68362
Office
Unavailable
Facility
$598.82
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 68362
Office
Unavailable
Facility
$608.18
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 68362
Office
Unavailable
Facility
$679.61
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 68362
Office
Unavailable
Facility
$678.86
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 68362
Office
Unavailable
Facility
$693.74
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 68362
Office
Unavailable
Facility
$690.67
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 68362
Office
Unavailable
Facility
$589.75
No comparable office rate is available.
Santa Cruz-Watsonville
California · 68362
Office
Unavailable
Facility
$610.42
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 68362
Office
Unavailable
Facility
$599.78
No comparable office rate is available.
Santa Rosa-Petaluma
California · 68362
Office
Unavailable
Facility
$616.28
No comparable office rate is available.
Stockton
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Vallejo
California · 68362
Office
Unavailable
Facility
$646.98
No comparable office rate is available.
Visalia
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Yuba City
California · 68362
Office
Unavailable
Facility
$578.69
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 68362
Office
Unavailable
Facility
$622.87
No comparable office rate is available.
Miami
Florida · 68362
Office
Unavailable
Facility
$603.72
No comparable office rate is available.
Chicago
Illinois · 68362
Office
Unavailable
Facility
$591.26
No comparable office rate is available.
Manhattan
New York · 68362
Office
Unavailable
Facility
$631.98
No comparable office rate is available.
Alaska*
Alaska · 68362
Office
Unavailable
Facility
$706.40
No comparable office rate is available.
Alabama
Alabama · 68362
Office
Unavailable
Facility
$517.75
No comparable office rate is available.
Arkansas
Arkansas · 68362
Office
Unavailable
Facility
$512.51
No comparable office rate is available.
Arizona
Arizona · 68362
Office
Unavailable
Facility
$548.32
No comparable office rate is available.
Colorado
Colorado · 68362
Office
Unavailable
Facility
$574.46
No comparable office rate is available.
Connecticut
Connecticut · 68362
Office
Unavailable
Facility
$589.50
No comparable office rate is available.
Delaware
Delaware · 68362
Office
Unavailable
Facility
$555.55
No comparable office rate is available.
Fort Lauderdale
Florida · 68362
Office
Unavailable
Facility
$580.62
No comparable office rate is available.
Rest Of Florida
Florida · 68362
Office
Unavailable
Facility
$559.24
No comparable office rate is available.
Atlanta
Georgia · 68362
Office
Unavailable
Facility
$568.85
No comparable office rate is available.
Rest Of Georgia
Georgia · 68362
Office
Unavailable
Facility
$535.92
No comparable office rate is available.
Hawaii, Guam
Hawaii · 68362
Office
Unavailable
Facility
$585.42
No comparable office rate is available.
Iowa
Iowa · 68362
Office
Unavailable
Facility
$524.31
No comparable office rate is available.
Idaho
Idaho · 68362
Office
Unavailable
Facility
$527.27
No comparable office rate is available.
East St. Louis
Illinois · 68362
Office
Unavailable
Facility
$561.24
No comparable office rate is available.
Rest Of Illinois
Illinois · 68362
Office
Unavailable
Facility
$549.50
No comparable office rate is available.
Suburban Chicago
Illinois · 68362
Office
Unavailable
Facility
$585.39
No comparable office rate is available.
Indiana
Indiana · 68362
Office
Unavailable
Facility
$529.36
No comparable office rate is available.
Kansas
Kansas · 68362
Office
Unavailable
Facility
$523.84
No comparable office rate is available.
Kentucky
Kentucky · 68362
Office
Unavailable
Facility
$529.04
No comparable office rate is available.
New Orleans
Louisiana · 68362
Office
Unavailable
Facility
$547.29
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 68362
Office
Unavailable
Facility
$528.96
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 68362
Office
Unavailable
Facility
$618.42
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 68362
Office
Unavailable
Facility
$573.10
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 68362
Office
Unavailable
Facility
$587.95
No comparable office rate is available.
Rest Of Maryland
Maryland · 68362
Office
Unavailable
Facility
$563.55
No comparable office rate is available.
Rest Of Maine
Maine · 68362
Office
Unavailable
Facility
$530.56
No comparable office rate is available.
Southern Maine
Maine · 68362
Office
Unavailable
Facility
$549.02
No comparable office rate is available.
Detroit
Michigan · 68362
Office
Unavailable
Facility
$565.59
No comparable office rate is available.
Rest Of Michigan
Michigan · 68362
Office
Unavailable
Facility
$539.93
No comparable office rate is available.
Minnesota
Minnesota · 68362
Office
Unavailable
Facility
$551.40
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 68362
Office
Unavailable
Facility
$543.27
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 68362
Office
Unavailable
Facility
$547.16
No comparable office rate is available.
Rest Of Missouri
Missouri · 68362
Office
Unavailable
Facility
$523.40
No comparable office rate is available.
Mississippi
Mississippi · 68362
Office
Unavailable
Facility
$517.96
No comparable office rate is available.
Montana**
Montana · 68362
Office
Unavailable
Facility
$559.42
No comparable office rate is available.
North Carolina
North Carolina · 68362
Office
Unavailable
Facility
$534.28
No comparable office rate is available.
North Dakota**
North Dakota · 68362
Office
Unavailable
Facility
$546.37
No comparable office rate is available.
Nebraska
Nebraska · 68362
Office
Unavailable
Facility
$525.95
No comparable office rate is available.
New Hampshire
New Hampshire · 68362
Office
Unavailable
Facility
$567.25
No comparable office rate is available.
Northern Nj
New Jersey · 68362
Office
Unavailable
Facility
$619.77
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 68362
Office
Unavailable
Facility
$596.47
No comparable office rate is available.
New Mexico
New Mexico · 68362
Office
Unavailable
Facility
$542.55
No comparable office rate is available.
Nevada**
Nevada · 68362
Office
Unavailable
Facility
$556.04
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 68362
Office
Unavailable
Facility
$644.90
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 68362
Office
Unavailable
Facility
$601.14
No comparable office rate is available.
Queens
New York · 68362
Office
Unavailable
Facility
$633.95
No comparable office rate is available.
Rest Of New York
New York · 68362
Office
Unavailable
Facility
$540.06
No comparable office rate is available.
Ohio
Ohio · 68362
Office
Unavailable
Facility
$537.27
No comparable office rate is available.
Oklahoma
Oklahoma · 68362
Office
Unavailable
Facility
$527.03
No comparable office rate is available.
Portland
Oregon · 68362
Office
Unavailable
Facility
$586.85
No comparable office rate is available.
Rest Of Oregon
Oregon · 68362
Office
Unavailable
Facility
$551.89
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 68362
Office
Unavailable
Facility
$579.31
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 68362
Office
Unavailable
Facility
$537.16
No comparable office rate is available.
Puerto Rico
Puerto Rico · 68362
Office
Unavailable
Facility
$561.96
No comparable office rate is available.
Rhode Island
Rhode Island · 68362
Office
Unavailable
Facility
$570.90
No comparable office rate is available.
South Carolina
South Carolina · 68362
Office
Unavailable
Facility
$536.61
No comparable office rate is available.
South Dakota**
South Dakota · 68362
Office
Unavailable
Facility
$544.83
No comparable office rate is available.
Tennessee
Tennessee · 68362
Office
Unavailable
Facility
$525.85
No comparable office rate is available.
Austin
Texas · 68362
Office
Unavailable
Facility
$572.43
No comparable office rate is available.
Beaumont
Texas · 68362
Office
Unavailable
Facility
$534.75
No comparable office rate is available.
Brazoria
Texas · 68362
Office
Unavailable
Facility
$554.54
No comparable office rate is available.
Dallas
Texas · 68362
Office
Unavailable
Facility
$557.83
No comparable office rate is available.
Fort Worth
Texas · 68362
Office
Unavailable
Facility
$555.54
No comparable office rate is available.
Galveston
Texas · 68362
Office
Unavailable
Facility
$556.11
No comparable office rate is available.
Houston
Texas · 68362
Office
Unavailable
Facility
$568.20
No comparable office rate is available.
Rest Of Texas
Texas · 68362
Office
Unavailable
Facility
$544.21
No comparable office rate is available.
Utah
Utah · 68362
Office
Unavailable
Facility
$541.79
No comparable office rate is available.
Virginia
Virginia · 68362
Office
Unavailable
Facility
$548.61
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 68362
Office
Unavailable
Facility
$561.96
No comparable office rate is available.
Vermont
Vermont · 68362
Office
Unavailable
Facility
$546.00
No comparable office rate is available.
Rest Of Washington
Washington · 68362
Office
Unavailable
Facility
$571.47
No comparable office rate is available.
Seattle (King Cnty)
Washington · 68362
Office
Unavailable
Facility
$627.82
No comparable office rate is available.
Wisconsin
Wisconsin · 68362
Office
Unavailable
Facility
$533.41
No comparable office rate is available.
West Virginia
West Virginia · 68362
Office
Unavailable
Facility
$535.27
No comparable office rate is available.
Wyoming**
Wyoming · 68362
Office
Unavailable
Facility
$553.73
No comparable office rate is available.
See how rates vary across the country
68362 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Madera is a Medicare payment area. Our Census mapping connects it to 17 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 68362 in Madera. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$636.56
$578.69 × 110% = $636.56
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 68362 in Madera.
PPRRVU2026_Oct_nonQPP.csv
7,549
- Code
- 68362
- Physician work
- 8.39
- Practice expense
- 7.70
- Malpractice
- 0.66
GPCI2026.csv
14
- Locality
- Madera
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.39 | × 1.017 | 8.5326 |
| Practice expense | 7.70 | × 1.096 | 8.4392 |
| Malpractice | 0.66 | × 0.536 | 0.3538 |
| Total RVUs | 17.3256 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Madera$578.69
Open 68362 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.39 | 1.017 |
| Practice expense | 7.7 | 1.096 |
| Malpractice | 0.66 | 0.536 |
(8.39 × 1.017 + 7.7 × 1.096 + 0.66 × 0.536) × $33.4009 = $578.69
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
68362 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $578.69 | RVU26D |
| 2026-07-01 | Not available in this setting | $578.69 | RVU26C |
| 2026-04-01 | Not available in this setting | $578.69 | RVU26B |
| 2026-01-01 | Not available in this setting | $578.69 | RVU26A |
| 2025-10-01 | Not available in this setting | $654.27 | RVU25D |
| 2025-07-01 | Not available in this setting | $654.27 | RVU25C |
| 2025-04-01 | Not available in this setting | $654.27 | RVU25B |
| 2025-01-01 | Not available in this setting | $654.27 | RVU25A |
68362 billing questions
How does this differ from 68360?
68362 is for fornix reconstruction using a mucous membrane graft. Use 68360 for the related fornix reconstruction without a graft.
When is a symblepharon repair code a better fit?
Codes 68330 and 68335 describe repair of symblepharon, without and with graft, respectively. Choose based on the operation performed; use 68362 when the service is reconstruction of the conjunctival fornix with a mucous membrane graft.
What should the operative report document?
Document the eye treated, the scarring and fornix shortening, the reconstructive work, and the mucous membrane graft. These details distinguish graft-based fornix reconstruction from adhesion release or reconstruction without graft.
How are bilateral procedures reported?
For bilateral performance, modifier 50 applies, and CMS pays the procedure at 150% under the supplied fee schedule rule.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment is restricted for this code. Co-surgeon payment is available only with supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,54668335,,Revise/graft eyelid lining,A,,8.25,7.65,NA,7.65,,0.67,16.57,16.57,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54768340,,Separate eyelid adhesions,A,,4.85,13.12,,5.16,,0.66,18.63,10.67,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54868360,,Revise eyelid lining,A,,5.04,10.92,,5.19,,0.40,16.36,10.63,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54968362,,Revise eyelid lining,A,,8.39,7.70,NA,7.70,,0.66,16.75,16.75,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55068371,,Harvest eye tissue alograft,A,,4.96,5.38,NA,5.38,,0.40,10.74,10.74,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55168399,,Unlisted px conjunctiva,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55268400,,I&d lacrimal gland,A,,1.70,7.02,,1.54,,0.14,8.86,3.38,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508