Billing code 68115: Conjunctival excisionMedicare rate & RVUs in Virginia
Report surgical removal of a conjunctival lesion larger than 1 cm, such as a growth requiring excision rather than biopsy or destruction.
Medicare pays $324.95–$379.78 for 68115 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. Which amount applies depends on the service address.
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 68115 covers
This service removes a lesion from the conjunctiva, the tissue lining the inner eyelids and covering the visible surface of the eye. Ophthalmologists commonly excise larger or suspicious ocular-surface growths in an office procedure room or surgical facility. The removed tissue may be submitted for pathologic examination; the code represents the excision itself, not the laboratory interpretation.
Choose this code when documentation supports a lesion larger than 1 cm and describes its size, location, laterality, and excision. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, 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.
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 68115 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $379.78 | $174.78 |
| Virginia | $324.95 | $153.89 |
How the 68115 rate is calculated
Each of 68115’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 · 68115
RVUs × geographic indexes × conversion factor
Work2.35
2.35 RVUs× 1.000 GPCI
Practice expense7.37
7.37 RVUs× 1.000 GPCI
Malpractice0.19
0.19 RVUs× 1.000 GPCI
Adjusted RVUs
9.9100
Conversion factor
$33.4009
Medicare rate
$331.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 68115
68115 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68115
Conjunctival excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68115
Conjunctival excision
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68115 without 50 · national office
$331.00
Conjunctival excision
68115-50 · Bilateral: 150%
$496.50
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).
68115 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 68110Conjunctival excision
- Use 68115 when the excised conjunctival lesion is larger than 1 cm; 68110 identifies the smaller-lesion size range.
- 68100Conjunctival biopsy
- 68100 is for conjunctival biopsy. Choose 68115 when the service is excision of a lesion larger than 1 cm.
- 68130Conjunctival excision
- 68130 identifies excision of a conjunctival lesion adjacent to the sclera; 68115 is distinguished by lesion size over 1 cm.
- 68135Lesion destruction
- 68135 is for destroying a conjunctival lesion. 68115 represents surgical excision of a lesion larger than 1 cm.
68115 billing questions
How does this differ from 68110?
68115 is for an excised conjunctival lesion larger than 1 cm; 68110 is for a lesion smaller than 1 cm. Document the lesion’s size to support the selection.
When would 68100 be more appropriate?
68100 describes a conjunctival biopsy. Use it when the service is a biopsy rather than excision of a lesion larger than 1 cm.
Is pathologic examination included?
The code represents removal of the lesion, not the laboratory examination of the specimen. A separately performed pathology service may be reported by the appropriate provider.
How is bilateral excision reported?
For bilateral treatment, report modifier 50; the CMS bilateral rule pays this code at 150%.
Are related postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this service. 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 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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