No office rate
68325 describes conjunctivoplasty with graft or extensive rearrangement. Choose 68326 when the operative objective is reconstruction of a shortened conjunctival fornix with a mucous membrane graft.
On this page
CMS RVU26D · Effective 2026-10-01
68326 Fornix reconstruction Medicare reimbursement rates in Tennessee
Reconstructs a shortened or scarred conjunctival fornix using a mucous membrane graft, restoring the pocket beneath the eyelid. Compare 68326 office and facility rates across CMS payment localities in Tennessee.
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 68326 in Tennessee?
Tennessee 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
$518.50
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 68326: Conjunctival fornix reconstruction with mucosal graft
Reconstructs a shortened or scarred conjunctival fornix using a mucous membrane graft, restoring the pocket beneath the eyelid.
An ophthalmic surgeon reconstructs the conjunctival fornix when scarring or tissue loss has shortened the pocket between the eyelid and eye. The surgeon releases contracted tissue and places a mucous membrane graft to restore depth and lining. This may be needed after severe ocular surface inflammation, burns, or scarring associated with symblepharon; the operation is typically performed in a surgical setting.
Report this code when the operative work is fornix reconstruction with a mucous membrane graft, rather than a more limited conjunctival rearrangement or adhesion repair. The record should identify the affected fornix, the scarring or tissue loss, the graft used, and the reconstructive work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 68326
- 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 RVU8.21 · 50%
- Practice expense (office) RVU7.65 · 46%
- Malpractice RVU0.67 · 4%
2.6K
Medicare services in 2024 · #2263 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.
68326 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$578.83
68330 is for symblepharon repair without a graft. This code involves fornix reconstruction using a mucous membrane graft.
No office rate
68335 describes symblepharon repair with a graft. Use this code when the documented service is reconstruction of the conjunctival fornix with a mucous membrane graft.
Compare 68326 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$518.50
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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 68326 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
7,543
- Code
- 68326
- Physician work
- 8.21
- Practice expense
- 7.65
- Malpractice
- 0.67
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.21 | × 1.000 | 8.2100 |
| Practice expense | 7.65 | × 0.909 | 6.9539 |
| Malpractice | 0.67 | × 0.537 | 0.3598 |
| Total RVUs | 15.5236 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$518.50
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.21 | 1 |
| Practice expense | 7.65 | 0.909 |
| Malpractice | 0.67 | 0.537 |
(8.21 × 1 + 7.65 × 0.909 + 0.67 × 0.537) × $33.4009 = $518.50
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.
68326 billing questions
When should this be chosen over a conjunctivoplasty code?
Use this code when the operative goal is to restore a shortened conjunctival fornix with a mucous membrane graft. A conjunctivoplasty code describes a different pattern of conjunctival rearrangement or graft work.
How is this different from symblepharon repair with a graft?
This code describes reconstruction of the fornix with a mucous membrane graft. A symblepharon repair code is selected when the documented procedure is repair of the adhesion itself.
What documentation supports reporting this code?
Document the involved fornix, the scarring or tissue loss that limits its depth, use of a mucous membrane graft, and the reconstructive steps performed.
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.
How is bilateral surgery handled?
CMS lists this as a bilateral procedure; with modifier 50, payment is 150%.
Can an assistant, co-surgeon, or surgical team be paid?
Assistant-at-surgery payment is restricted 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.
7,54068200,,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
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
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780