$221.12
Use 68115 when the excised conjunctival lesion is larger than 1 cm; 68110 identifies the smaller-lesion size range.
On this page
CMS RVU26D · Effective 2026-10-01
68115 Conjunctival excision Medicare reimbursement rates in Idaho
Report surgical removal of a conjunctival lesion larger than 1 cm, such as a growth requiring excision rather than biopsy or destruction. Compare 68115 office and facility rates across CMS payment localities in Idaho.
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.
What does Medicare pay for 68115 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$307.97
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$147.87
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmology procedure
About 68115: Excision of conjunctival lesion over one centimeter
Report surgical removal of a conjunctival lesion larger than 1 cm, such as a growth requiring excision rather than biopsy or destruction.
This service removes a lesion from the conjunctiva, the tissue lining the inner eyelids and covering the visible surface of the eye. Ophthalmologists commonly excise larger or suspicious ocular-surface growths in an office procedure room or surgical facility. The removed tissue may be submitted for pathologic examination; the code represents the excision itself, not the laboratory interpretation.
Choose this code when documentation supports a lesion larger than 1 cm and describes its size, location, laterality, and excision. Medicare includes related postoperative visits during the 10-day global period. 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%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 68115
- 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 RVU2.35 · 24%
- Practice expense (office) RVU7.37 · 74%
- Malpractice RVU0.19 · 2%
2.1K
Medicare services in 2024 · #2417 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.
68115 compared with similar codes
Office rates for Idaho, from the same CMS release.
$167.21
68100 is for conjunctival biopsy. Choose 68115 when the service is excision of a lesion larger than 1 cm.
$517.41
68130 identifies excision of a conjunctival lesion adjacent to the sclera; 68115 is distinguished by lesion size over 1 cm.
$149.56
68135 is for destroying a conjunctival lesion. 68115 represents surgical excision of a lesion larger than 1 cm.
Compare 68115 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Idaho →
Office / nonfacility
$307.97
Facility
$147.87
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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 68115 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
7,537
- Code
- 68115
- Physician work
- 2.35
- Practice expense
- 7.37
- Malpractice
- 0.19
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.35 | × 1.000 | 2.3500 |
| Practice expense | 7.37 | × 0.920 | 6.7804 |
| Malpractice | 0.19 | × 0.473 | 0.0899 |
| Total RVUs | 9.2203 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$307.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.35 | 1 |
| Practice expense | 7.37 | 0.92 |
| Malpractice | 0.19 | 0.473 |
(2.35 × 1 + 7.37 × 0.92 + 0.19 × 0.473) × $33.4009 = $307.97
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.35 | 1 |
| Practice expense | 2.16 | 0.92 |
| Malpractice | 0.19 | 0.473 |
(2.35 × 1 + 2.16 × 0.92 + 0.19 × 0.473) × $33.4009 = $147.87
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.
68115 billing questions
How does this differ from 68110?
68115 is for an excised conjunctival lesion larger than 1 cm; 68110 is for a lesion smaller than 1 cm. Document the lesion’s size to support the selection.
When would 68100 be more appropriate?
68100 describes a conjunctival biopsy. Use it when the service is a biopsy rather than excision of a lesion larger than 1 cm.
Is pathologic examination included?
The code represents removal of the lesion, not the laboratory examination of the specimen. A separately performed pathology service may be reported by the appropriate provider.
How is bilateral excision reported?
For bilateral treatment, report modifier 50; the CMS bilateral rule pays this code at 150%.
Are related postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this service. 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.
7,53468040,,Treatment of eyelid lesions,A,,0.83,0.98,,0.32,,0.04,1.85,1.19,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53568100,,Biopsy conjunctiva,A,,1.32,3.95,,1.00,,0.11,5.38,2.43,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53668110,,Exc les conjunctiva <1 cm,A,,1.77,5.20,,1.95,,0.14,7.11,3.86,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53768115,,Exc les conjunctiva >1 cm,A,,2.35,7.37,,2.16,,0.19,9.91,4.70,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53868130,,Exc les conjunctiva adj scl,A,,4.97,11.23,,5.34,,0.40,16.60,10.71,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,53968135,,Destruction les conjunctiva,A,,1.84,2.79,,1.90,,0.15,4.78,3.89,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54068200,,Treat eyelid by injection,A,,0.48,0.72,,0.35,,0.04,1.24,0.87,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772