Billing code 68340: Adhesion releaseMedicare rate & RVUs in Modesto

In Modesto, Medicare pays $656.85 for 68340 in the office and $365.46 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 68340 nationwide

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

What 68340 covers

This procedure releases abnormal scar tissue or other adhesions that bind eyelid structures together, including fusion at the lid margins. A typical clinical situation is acquired or congenital ankyloblepharon, where adhesions restrict opening or separation of the lids. An ophthalmologist, often an oculoplastic surgeon, performs the release in an operative setting; Medicare records services in both office and facility settings.

Report the code when the operative work is directed at separating eyelid adhesions, rather than reconstructing damaged eyelid lining. The note should identify the affected eyelid or lids, the location and extent of the adhesion, the functional or anatomic problem, and the release performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 Modesto compares for 68340

Across 109 of 109 payment localities, the office rate for 68340 runs from $549.78 in Arkansas to $823.54 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). Modesto pays $656.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

68340 rates by state

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

See 68340 in every payment locality

How the 68340 rate is calculated

Each of 68340’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 68340

68340 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

Codes related to 68340

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

How 68340 has changed in Modesto

Price 68340 for an earlier date of service

Where the Modesto rate applies

Modesto is a Medicare payment area, not a city. Our Census mapping connects it to 33 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

• 68340 in Modesto
• 68340 in Airport
• 68340 in Bret Harte
• 68340 in Bystrom
• 68340 in Ceres
• 68340 in Cowan
• 68340 in Crows Landing
• 68340 in Del Rio

Browse all communities in California

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