Billing code 68325: ConjunctivoplastyMedicare rate & RVUs in Oregon
Reports conjunctival lining reconstruction using a mucous membrane graft, commonly to restore a scarred or shortened eyelid fornix.
CMS doesn’t publish an office rate for 68325 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 68325 covers
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.
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.
Where 68325 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $587.90 |
| Rest Of Oregon | Unavailable | $552.89 |
How the 68325 rate is calculated
Each of 68325’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.
How the rate is built · 68325
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.41Practice expense 7.71Malpractice 0.66
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 68325
68325 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68325
Conjunctivoplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68325
Conjunctivoplasty
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68325 without 50 · national facility
$560.47
Conjunctivoplasty
68325-50 · Bilateral: 150%
$840.71
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
68325 compared with similar codes
Compare codes
68325 vs 68320 vs 68326 vs 68330 vs 68335: national Medicare rates
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How to choose
- 68320Conjunctivoplasty
- 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.
- 68326Fornix reconstruction
- 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.
- 68330Symblepharon repair
- 68330 describes eyelid-lining revision without the mucous membrane graft reconstruction represented by 68325; select the code matching the actual procedure.
- 68335Symblepharon repair
- 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.
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 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
Show the CMS file lines behind this rate
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