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CMS RVU26D · Effective 2026-10-01

68020 in Modesto

Office / nonfacility

$127.56

Base rate per service

Facility setting

$98.64

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.

Ophthalmology

About 68020: Conjunctival cyst incision and drainage

Report this service when an ophthalmologist opens and drains a cyst of the conjunctiva, rather than excising a conjunctival lesion or treating an eyelid lesion.

This service involves making an incision in a conjunctival cyst and draining its contents. Ophthalmologists typically perform it as a minor procedure in an office or facility setting, often after examining the eye and identifying the cyst on the conjunctival surface. The code is for a cyst of the conjunctiva, not an abscess in the eyelid or a chalazion treated by excision.

Report the service when the documented treatment is incision and drainage; documentation should identify the conjunctival cyst and the procedure performed. The CMS global period is 10 days, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

CMS billing rules for 68020

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.38 · 38%
  • Practice expense (office) RVU2.16 · 60%
  • Malpractice RVU0.09 · 2%

2.5K

Medicare services in 2024 · #2309 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.

68020 compared with similar codes

Office rates for Modesto, from the same CMS release.

67700

Eyelid abscess drainage

Abscess of the eyelid

$301.83

This code is for a conjunctival cyst. Code 67700 addresses incision and drainage of an abscess in the eyelid.

68040

Eyelid lesion treatment

Without incision, excluding chalazion

$64.79

This code drains a conjunctival cyst; 68040 is treatment of eyelid lesions, such as molluscum contagiosum or milia.

68110

Conjunctival excision

Lesion under 1 cm

$252.99

Use this code for incision and drainage of a conjunctival cyst. Code 68110 describes excision of a conjunctival lesion up to 1 cm.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 68020 is $127.87—$0.31 higher than the $127.56 rate in Modesto. Both use the same code, release and participation basis.

68020 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $127.56

  2. Bakersfield

    $127.87

    $0.31 higher than Modesto

  3. Chico

    $127.56

    The same base rate than Modesto

  4. El Centro

    $127.58

    $0.02 higher than Modesto

  5. Fresno

    $127.56

    The same base rate than Modesto

  6. Hanford-Corcoran

    $127.56

    The same base rate than Modesto

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $135.33

    $7.77 higher than Modesto

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 68020 ranges from $109.61 in Arkansas to $156.81 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Madera

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Merced

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Napa

    California · 68020

    Office

    $145.61

    Facility

    $110.83

    $18.05 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 68020

    Office

    $134.53

    Facility

    $103.34

    $6.97 higher than Modesto for the office setting.

  • Redding

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 68020

    Office

    $128.56

    Facility

    $99.64

    $1.00 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 68020

    Office

    $133.27

    Facility

    $102.58

    $5.71 higher than Modesto for the office setting.

  • Salinas

    California · 68020

    Office

    $132.75

    Facility

    $102.17

    $5.19 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 68020

    Office

    $135.39

    Facility

    $103.83

    $7.83 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 68020

    Office

    $153.58

    Facility

    $116.37

    $26.02 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 68020

    Office

    $153.48

    Facility

    $116.27

    $25.92 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 68020

    Office

    $156.81

    Facility

    $118.76

    $29.25 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 68020

    Office

    $156.39

    Facility

    $118.34

    $28.83 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 68020

    Office

    $130.66

    Facility

    $100.61

    $3.10 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 68020

    Office

    $136.33

    Facility

    $104.27

    $8.77 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 68020

    Office

    $133.12

    Facility

    $102.35

    $5.56 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 68020

    Office

    $137.68

    Facility

    $105.28

    $10.12 higher than Modesto for the office setting.

  • Stockton

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 68020

    Office

    $145.47

    Facility

    $110.69

    $17.91 higher than Modesto for the office setting.

  • Visalia

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 68020

    Office

    $127.56

    Facility

    $98.64

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 68020

    Office

    $136.92

    Facility

    $105.83

    $9.36 higher than Modesto for the office setting.

  • Miami

    Florida · 68020

    Office

    $128.80

    Facility

    $101.33

    $1.24 higher than Modesto for the office setting.

  • Chicago

    Illinois · 68020

    Office

    $125.82

    Facility

    $99.30

    $1.74 lower than Modesto for the office setting.

  • Manhattan

    New York · 68020

    Office

    $137.64

    Facility

    $106.98

    $10.08 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 68020

    Office

    $147.63

    Facility

    $119.53

    $20.07 higher than Modesto for the office setting.

  • Alabama

    Alabama · 68020

    Office

    $110.92

    Facility

    $87.83

    $16.64 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 68020

    Office

    $109.61

    Facility

    $86.95

    $17.95 lower than Modesto for the office setting.

  • Arizona

    Arizona · 68020

    Office

    $118.58

    Facility

    $93.01

    $8.98 lower than Modesto for the office setting.

  • Colorado

    Colorado · 68020

    Office

    $125.76

    Facility

    $97.68

    $1.80 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 68020

    Office

    $128.35

    Facility

    $99.94

    $0.79 higher than Modesto for the office setting.

  • Delaware

    Delaware · 68020

    Office

    $120.31

    Facility

    $94.24

    $7.25 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 68020

    Office

    $124.61

    Facility

    $97.88

    $2.95 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 68020

    Office

    $119.58

    Facility

    $94.36

    $7.98 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 68020

    Office

    $123.14

    Facility

    $96.33

    $4.42 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 68020

    Office

    $114.03

    Facility

    $90.49

    $13.53 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 68020

    Office

    $129.86

    Facility

    $99.86

    $2.30 higher than Modesto for the office setting.

  • Iowa

    Iowa · 68020

    Office

    $113.30

    Facility

    $89.16

    $14.26 lower than Modesto for the office setting.

  • Idaho

    Idaho · 68020

    Office

    $113.89

    Facility

    $89.61

    $13.67 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 68020

    Office

    $118.52

    Facility

    $94.25

    $9.04 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 68020

    Office

    $116.66

    Facility

    $92.57

    $10.90 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 68020

    Office

    $125.84

    Facility

    $98.74

    $1.72 lower than Modesto for the office setting.

  • Indiana

    Indiana · 68020

    Office

    $114.43

    Facility

    $89.97

    $13.13 lower than Modesto for the office setting.

  • Kansas

    Kansas · 68020

    Office

    $112.83

    Facility

    $88.97

    $14.73 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 68020

    Office

    $112.98

    Facility

    $89.52

    $14.58 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 68020

    Office

    $117.40

    Facility

    $92.57

    $10.16 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 68020

    Office

    $112.82

    Facility

    $89.47

    $14.74 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 68020

    Office

    $136.80

    Facility

    $105.30

    $9.24 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 68020

    Office

    $125.20

    Facility

    $97.41

    $2.36 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 68020

    Office

    $127.96

    Facility

    $99.65

    $0.40 higher than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 68020

    Office

    $122.33

    Facility

    $95.62

    $5.23 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 68020

    Office

    $114.34

    Facility

    $90.06

    $13.22 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 68020

    Office

    $119.49

    Facility

    $93.34

    $8.07 lower than Modesto for the office setting.

  • Detroit

    Michigan · 68020

    Office

    $120.78

    Facility

    $95.32

    $6.78 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 68020

    Office

    $115.36

    Facility

    $91.27

    $12.20 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 68020

    Office

    $121.22

    Facility

    $94.07

    $6.34 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 68020

    Office

    $116.78

    Facility

    $92.00

    $10.78 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 68020

    Office

    $117.79

    Facility

    $92.67

    $9.77 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 68020

    Office

    $111.21

    Facility

    $88.47

    $16.35 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 68020

    Office

    $110.43

    Facility

    $87.71

    $17.13 lower than Modesto for the office setting.

  • Montana**

    Montana · 68020

    Office

    $121.24

    Facility

    $94.85

    $6.32 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 68020

    Office

    $115.33

    Facility

    $90.71

    $12.23 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 68020

    Office

    $119.46

    Facility

    $93.07

    $8.10 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 68020

    Office

    $113.82

    Facility

    $89.47

    $13.74 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 68020

    Office

    $123.83

    Facility

    $96.36

    $3.73 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 68020

    Office

    $135.90

    Facility

    $105.29

    $8.34 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 68020

    Office

    $130.02

    Facility

    $101.20

    $2.46 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 68020

    Office

    $115.86

    Facility

    $91.66

    $11.70 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 68020

    Office

    $120.82

    Facility

    $94.40

    $6.74 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 68020

    Office

    $140.41

    Facility

    $109.03

    $12.85 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 68020

    Office

    $130.80

    Facility

    $101.91

    $3.24 higher than Modesto for the office setting.

  • Queens

    New York · 68020

    Office

    $138.65

    Facility

    $107.47

    $11.09 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 68020

    Office

    $116.75

    Facility

    $91.68

    $10.81 lower than Modesto for the office setting.

  • Ohio

    Ohio · 68020

    Office

    $114.99

    Facility

    $90.90

    $12.57 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 68020

    Office

    $112.86

    Facility

    $89.29

    $14.70 lower than Modesto for the office setting.

  • Portland

    Oregon · 68020

    Office

    $129.22

    Facility

    $99.91

    $1.66 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 68020

    Office

    $120.06

    Facility

    $93.78

    $7.50 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 68020

    Office

    $125.61

    Facility

    $98.14

    $1.95 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 68020

    Office

    $115.16

    Facility

    $90.94

    $12.40 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 68020

    Office

    $121.99

    Facility

    $95.32

    $5.57 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 68020

    Office

    $124.18

    Facility

    $96.92

    $3.38 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 68020

    Office

    $115.31

    Facility

    $90.93

    $12.25 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 68020

    Office

    $119.25

    Facility

    $92.86

    $8.31 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 68020

    Office

    $113.29

    Facility

    $89.30

    $14.27 lower than Modesto for the office setting.

  • Austin

    Texas · 68020

    Office

    $125.18

    Facility

    $97.26

    $2.38 lower than Modesto for the office setting.

  • Beaumont

    Texas · 68020

    Office

    $114.54

    Facility

    $90.53

    $13.02 lower than Modesto for the office setting.

  • Brazoria

    Texas · 68020

    Office

    $120.30

    Facility

    $94.15

    $7.26 lower than Modesto for the office setting.

  • Dallas

    Texas · 68020

    Office

    $120.94

    Facility

    $94.66

    $6.62 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 68020

    Office

    $120.26

    Facility

    $94.24

    $7.30 lower than Modesto for the office setting.

  • Galveston

    Texas · 68020

    Office

    $120.59

    Facility

    $94.39

    $6.97 lower than Modesto for the office setting.

  • Houston

    Texas · 68020

    Office

    $122.24

    Facility

    $96.04

    $5.32 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 68020

    Office

    $117.27

    Facility

    $92.23

    $10.29 lower than Modesto for the office setting.

  • Utah

    Utah · 68020

    Office

    $116.61

    Facility

    $91.81

    $10.95 lower than Modesto for the office setting.

  • Virginia

    Virginia · 68020

    Office

    $119.13

    Facility

    $93.20

    $8.43 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 68020

    Office

    $121.99

    Facility

    $95.32

    $5.57 lower than Modesto for the office setting.

  • Vermont

    Vermont · 68020

    Office

    $119.04

    Facility

    $92.92

    $8.52 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 68020

    Office

    $124.95

    Facility

    $97.16

    $2.61 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 68020

    Office

    $139.38

    Facility

    $107.00

    $11.82 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 68020

    Office

    $116.13

    Facility

    $90.86

    $11.43 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 68020

    Office

    $113.09

    Facility

    $90.16

    $14.47 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 68020

    Office

    $120.46

    Facility

    $94.08

    $7.10 lower than Modesto for the office setting.

See how rates vary across the country

68020 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$109.61

$147.63

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$147.631
AL$110.921
AR$109.611
AZ$118.581
CA$127.56–$156.8129
CO$125.761
CT$128.351
DC$136.921
DE$120.311
FL$119.58–$128.803
GA$114.03–$123.142
GU$129.861
HI$129.861
IA$113.301
ID$113.891
IL$116.66–$125.844
IN$114.431
KS$112.831
KY$112.981
LA$112.82–$117.402
MA$125.20–$136.802
MD$122.33–$136.923
ME$114.34–$119.492
MI$115.36–$120.782
MN$121.221
MO$111.21–$117.793
MS$110.431
MT$121.241
NC$115.331
ND$119.461
NE$113.821
NH$123.831
NJ$130.02–$135.902
NM$115.861
NV$120.821
NY$116.75–$140.415
OH$114.991
OK$112.861
OR$120.06–$129.222
PA$115.16–$125.612
PR$121.991
RI$124.181
SC$115.311
SD$119.251
TN$113.291
TX$114.54–$125.188
UT$116.611
VA$119.13–$136.922
VI$121.991
VT$119.041
WA$124.95–$139.382
WI$116.131
WV$113.091
WY$120.461

Explore 68020 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 68020 in Modesto, the physician’s office rate is $127.56 and the facility-setting rate is $98.64: a difference of $28.92.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 68020 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$140.32

$127.56 × 110% = $140.32

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.

Compare your contract offer →

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 68020 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

7,533

Code
68020
Physician work
1.38
Practice expense
2.16
Malpractice
0.09

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 68020 in Modesto
ComponentRVULocality factorAdjusted
Physician work1.38× 1.0171.4035
Practice expense2.16× 1.0962.3674
Malpractice0.09× 0.5360.0482
Total RVUs3.8191
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$127.56

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 68020 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.381.017
Practice expense2.161.096
Malpractice0.090.536

(1.38 × 1.017 + 2.16 × 1.096 + 0.09 × 0.536) × $33.4009 = $127.56

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.381.017
Practice expense1.371.096
Malpractice0.090.536

(1.38 × 1.017 + 1.37 × 1.096 + 0.09 × 0.536) × $33.4009 = $98.64

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

68020 · Office / nonfacility

$127.56

Effective 2026-10-01

The base rate is $4.93 higher than on 2025-10-01, moving from $122.63 to $127.56 (4.0%).

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

    $122.63changed to$127.56

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.42 changed to 1.38
    • Practice expense RVU 2.10 changed to 2.16
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $122.63

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$127.56$98.64RVU26D
2026-07-01$127.56$98.64RVU26C
2026-04-01$127.56$98.64RVU26B
2026-01-01$127.56$98.64RVU26A
2025-10-01$122.63$110.61RVU25D
2025-07-01$122.63$110.61RVU25C
2025-04-01$122.63$110.61RVU25B
2025-01-01$122.63$110.61RVU25A

68020 billing questions

When is this code used instead of an eyelid drainage code?

Use this code for incision and drainage of a cyst in the conjunctiva. A collection in the eyelid itself is a different anatomic service.

Is this the code for excising a conjunctival cyst?

No. This code describes opening and draining the cyst. When the service is excision of a conjunctival lesion, select the code that matches the excision and lesion size.

Are related postoperative visits separately reportable?

Related postoperative visits within the 10-day global period are included in the procedure.

How is bilateral treatment reported?

For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.

How does payment work when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are not permitted.

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.

RVUs for 68020PPRRVU2026_Oct_nonQPP.csv, line 7,533 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet