$578.87–$610.18
68360 represents reconstruction of the cul-de-sac. Choose 68340 when the documented procedure is severing adhesions rather than reconstructing the fornix.
On this page
CMS RVU26D · Effective 2026-10-01
68360 Conjunctivoplasty Medicare reimbursement rates in Maine
An ophthalmic surgeon uses this code for surgical reconstruction of the conjunctival cul-de-sac, often when scarring has contracted the eyelid lining. Compare 68360 office and facility rates across CMS payment localities in Maine.
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 68360 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$512.21–$538.23
2 of 2 localities have a supported rate.
Facility setting
$336.13–$348.56
2 of 2 localities have a supported rate.
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 68360: Conjunctival cul-de-sac reconstruction
An ophthalmic surgeon uses this code for surgical reconstruction of the conjunctival cul-de-sac, often when scarring has contracted the eyelid lining.
CPT 68360 describes surgical reconstruction of the conjunctival cul-de-sac, the pocket formed by the eyelid lining and the eye surface. Ophthalmologists may perform it to restore the fornix when scarring has shortened or distorted the lining, including after injury, inflammation, or prior surgery. These procedures are generally performed in a surgical facility rather than an office.
Select the code from the operative work documented: the record should identify the affected side, the cul-de-sac or fornix addressed, the extent of reconstruction, and the technique used. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 68360
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.04 · 31%
- Practice expense (office) RVU10.92 · 67%
- Malpractice RVU0.40 · 2%
55
Medicare services in 2024 · #5306 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.
68360 compared with similar codes
Office rates for Maine, from the same CMS release.
$699.62–$736.27
68320 is a related conjunctivoplasty code associated with a graft or extensive rearrangement. Base code selection on the documented procedure and the specific reconstruction performed.
No office rate
Both codes concern cul-de-sac reconstruction. Review the operative technique and the precise service represented by each code before selecting one.
Compare 68360 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$512.21
Facility
$336.13
Southern Maine →
Office / nonfacility
$538.23
Facility
$348.56
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
68360 billing questions
When is 68360 appropriate instead of 68340?
Use 68360 for reconstruction of the conjunctival cul-de-sac. Code 68340 describes severing adhesions; it is the more fitting choice when the documented service is limited to releasing conjunctival adhesions.
What documentation supports 68360?
Document the side and specific cul-de-sac or fornix treated, the scarring or distortion, and the reconstructive work performed. The operative report should make clear how the work restores the eyelid lining.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The routine related follow-up is not separately represented by another service code.
How is 68360 reported when both sides are reconstructed?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
7,54568330,,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
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