$122.33–$127.63
Choose 68200 for medication placed beneath the conjunctiva; choose 67028 when the medication is injected into the vitreous.
On this page
CMS RVU26D · Effective 2026-10-01
68200 Eye injection Medicare reimbursement rates in New Jersey
Reports medication placed beneath the conjunctiva of the eye, rather than into the vitreous, eyelid skin, or another ocular tissue plane. Compare 68200 office and facility rates across CMS payment localities in New Jersey.
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 68200 in New Jersey?
New Jersey 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
$44.40–$46.37
2 of 2 localities have a supported rate.
Facility setting
$30.91–$32.03
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.
Ophthalmology procedure
About 68200: Subconjunctival medication injection
Reports medication placed beneath the conjunctiva of the eye, rather than into the vitreous, eyelid skin, or another ocular tissue plane.
Report 68200 when an ophthalmic clinician delivers medication into the subconjunctival tissue, the loose layer over the white of the eye. The injection may be performed in an eye office or outpatient facility for treatment or as part of perioperative eye care. Documentation should identify the eye, injection site, medication, and clinical purpose, making clear that the medication was placed beneath the conjunctiva rather than into the eyelid or another ocular space.
Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. For treatment of both eyes, 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 68200
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU0.48 · 39%
- Practice expense (office) RVU0.72 · 58%
- Malpractice RVU0.04 · 3%
3.6K
Medicare services in 2024 · #2055 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.
68200 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$55.28–$57.51
The documented injection plane distinguishes the codes: 68200 is subconjunctival, while 67515 is associated with the sub-Tenon's plane.
$84.09–$87.47
Code 67500 describes a peribulbar anesthetic injection for regional anesthesia; 68200 reports medication placed beneath the conjunctiva.
Compare 68200 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
Northern Nj →
Office / nonfacility
$46.37
Facility
$32.03
Rest Of New Jersey →
Office / nonfacility
$44.40
Facility
$30.91
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68200 billing questions
How is 68200 distinguished from an intravitreal injection?
Use 68200 when the medication is placed beneath the conjunctiva. An injection into the vitreous is reported with 67028.
What should the procedure note document?
Record the medication, clinical purpose, laterality, and the subconjunctival injection site. The documented tissue plane helps distinguish this service from injections into other ocular spaces.
How is bilateral treatment reported?
When both eyes are treated, report modifier 50; Medicare pays the bilateral procedure at 150%.
Can 68200 be reported with another procedure in the same session?
Same-day preoperative and postoperative care is included in the 0-day global period. When other procedures are performed in the same session, Medicare applies its multiple-procedure reduction to the additional procedures.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 68200. 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.
7,53768115,,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
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