$184.49
68100 is for sampling conjunctival tissue to obtain a diagnosis. Use 68135 when the lesion is treated by destruction without a diagnostic tissue sample.
On this page
CMS RVU26D · Effective 2026-10-01
68135 Lesion destruction Medicare reimbursement rates in Rhode Island
Reports destruction of a lesion on the conjunctiva, such as a papillomatous growth, when treatment removes or ablates it without excision. Compare 68135 office and facility rates across CMS payment localities in Rhode Island.
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 68135 in Rhode Island?
Rhode Island 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
$163.36
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$132.65
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 68135: Conjunctival lesion destruction
Reports destruction of a lesion on the conjunctiva, such as a papillomatous growth, when treatment removes or ablates it without excision.
An ophthalmologist typically uses a destructive technique, such as cryotherapy or cautery, to treat a lesion on the conjunctiva, the membrane covering the eye’s front surface and lining the eyelids. A conjunctival papilloma is one example of a lesion that may be treated this way. The service may be performed in an office or facility setting, depending on the procedure and patient circumstances.
Select this code when the lesion is destroyed rather than removed by excision or sampled for diagnosis. Document the treated eye, lesion location and characteristics, and method of destruction. The 10-day global period includes related postoperative visits during that period. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 68135
- 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 RVU1.84 · 38%
- Practice expense (office) RVU2.79 · 58%
- Malpractice RVU0.15 · 3%
819
Medicare services in 2024 · #3124 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.
68135 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$243.83
68110 describes excision of a conjunctival lesion up to 1 cm. Choose 68135 when the method is destruction, not surgical removal.
$339.93
68115 describes excision of a conjunctival lesion over 1 cm. It differs from 68135 by removal method, not simply by lesion size.
$568.54
68130 describes excision of a conjunctival lesion adjacent to the sclera. Use 68135 for destruction rather than excision.
Compare 68135 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
Rhode Island →
Office / nonfacility
$163.36
Facility
$132.65
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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 68135 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,539
- Code
- 68135
- Physician work
- 1.84
- Practice expense
- 2.79
- Malpractice
- 0.15
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.84 | × 1.019 | 1.8750 |
| Practice expense | 2.79 | × 1.033 | 2.8821 |
| Malpractice | 0.15 | × 0.892 | 0.1338 |
| Total RVUs | 4.8908 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$163.36
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.84 | 1.019 |
| Practice expense | 2.79 | 1.033 |
| Malpractice | 0.15 | 0.892 |
(1.84 × 1.019 + 2.79 × 1.033 + 0.15 × 0.892) × $33.4009 = $163.36
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.84 | 1.019 |
| Practice expense | 1.9 | 1.033 |
| Malpractice | 0.15 | 0.892 |
(1.84 × 1.019 + 1.9 × 1.033 + 0.15 × 0.892) × $33.4009 = $132.65
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.
68135 billing questions
When should this code be used instead of a conjunctival excision code?
Use this code when the lesion is destroyed in place. Use an excision code when the lesion is surgically removed; the applicable excision code depends on the procedure and lesion circumstances.
How does this differ from a conjunctival biopsy?
Destruction treats the lesion without removing a specimen for histologic examination. A biopsy is used when tissue is sampled for diagnosis.
Does the 10-day global period include follow-up visits?
Related postoperative visits during the 10 days after the procedure are included in the global period.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS values the bilateral procedure at 150%.
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 other procedures are paid at 50%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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.
7,53668110,,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
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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537