$700.90
Both involve conjunctivoplasty, but 68325 is selected for reconstruction using a mucous membrane graft. Use 68320 when its distinct technique is supported by the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
68325 Conjunctivoplasty Medicare reimbursement rates in Indiana
Reports conjunctival lining reconstruction using a mucous membrane graft, commonly to restore a scarred or shortened eyelid fornix. Compare 68325 office and facility rates across CMS payment localities in Indiana.
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 68325 in Indiana?
Indiana 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
No supported rate
Facility setting
$530.34
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Ophthalmic surgery
About 68325: Conjunctivoplasty with mucous membrane graft
Reports conjunctival lining reconstruction using a mucous membrane graft, commonly to restore a scarred or shortened eyelid fornix.
An ophthalmologist, often an oculoplastic surgeon, uses this procedure to reconstruct conjunctival lining with a mucous membrane graft. It is used when scarring, contraction, trauma, or adhesions leave the eyelid fornix shortened or inadequately lined, such as in complex ocular-surface or socket reconstruction. The surgeon prepares the affected area and places the graft to restore the lining and support eyelid movement or prosthesis retention. The graft procurement is included in the service.
Select this code when the operative report supports conjunctivoplasty with a mucous membrane graft; document the defect, reconstruction, and graft used. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 68325
- 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 RVU8.41 · 50%
- Practice expense (office) RVU7.71 · 46%
- Malpractice RVU0.66 · 4%
67
Medicare services in 2024 · #5176 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.
68325 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This is a neighboring conjunctivoplasty code with a different specified graft or technique. Base the choice on the operative method, not simply on the presence of a graft.
$585.65
68330 describes eyelid-lining revision without the mucous membrane graft reconstruction represented by 68325; select the code matching the actual procedure.
No office rate
68335 is for a graft-related symblepharon repair, while 68325 represents conjunctivoplasty with a mucous membrane graft. Distinguish them by the repair performed and documented.
Compare 68325 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
Indiana →
Office / nonfacility
Unavailable
Facility
$530.34
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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 68325 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
7,542
- Code
- 68325
- Physician work
- 8.41
- Practice expense
- 7.71
- Malpractice
- 0.66
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.41 | × 1.000 | 8.4100 |
| Practice expense | 7.71 | × 0.927 | 7.1472 |
| Malpractice | 0.66 | × 0.486 | 0.3208 |
| Total RVUs | 15.8779 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$530.34
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.41 | 1 |
| Practice expense | 7.71 | 0.927 |
| Malpractice | 0.66 | 0.486 |
(8.41 × 1 + 7.71 × 0.927 + 0.66 × 0.486) × $33.4009 = $530.34
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.
68325 billing questions
When should 68325 be chosen over another conjunctivoplasty code?
Use 68325 when the documented reconstruction uses a mucous membrane graft. Choose among related conjunctivoplasty codes according to the specific graft or technique documented.
Is obtaining the mucous membrane graft separately reportable?
Graft procurement is included in 68325, so it is not separately reported as a distinct harvest service for this reconstruction.
What documentation supports 68325?
Document the conjunctival defect or contracture, the reconstructive work performed, and use of a mucous membrane graft. The record should make clear why lining reconstruction was needed.
How is bilateral 68325 reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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.
7,53968135,,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
7,54168320,,Revise/graft eyelid lining,A,,6.47,15.39,,7.04,,0.51,22.37,14.02,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54268325,,Revise/graft eyelid lining,A,,8.41,7.71,NA,7.71,,0.66,16.78,16.78,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54368326,,Revise/graft eyelid lining,A,,8.21,7.65,NA,7.65,,0.67,16.53,16.53,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54468328,,Revise/graft eyelid lining,A,,9.21,7.99,NA,7.99,,0.73,17.93,17.93,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,54568330,,Revise eyelid lining,A,,5.64,12.60,,5.82,,0.44,18.68,11.90,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915