CPT 68020 Surgery - Eye
Incise/drain eyelid lining Cost
Body System: Eye
Medicare Facility Rate
$95
CMS PFS CY2026
Medicare Non-Facility Rate
$121
Office/clinic setting
Hospital Outpatient
$1
OPPS rate
Surgery Center (ASC)
$73
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
1.38
Work RVU
1.37
Facility PE RVU
0.09
Malpractice RVU
3.63
Total RVU
Frequently Asked Questions
How much does Incise/drain eyelid lining cost?
The Medicare facility rate is $95. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $1. Ambulatory surgery center rate: $73.
How much does Incise/drain eyelid lining cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $95.