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CPT code 68530: Tear duct clearance, obstruction removal2026 Medicare rate & RVUs in Chicago, IL

Removal of obstructing material from the lacrimal drainage duct, reported when a tear duct concretion or similar blockage is cleared.

CMS RVU26DEffective Oct 1, 2026One payment locality2.4K Medicare services in 2024

In Chicago, IL, Medicare pays $448.02 for 68530 in the office and $226.13 when it’s performed in a hospital or facility.

$448.02Office (non-facility)
$226.13Hospital or facility
+3.3%vs the national office rate ($433.54)

Check a contract rate as a % of Medicare · 68530 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 68530 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chicago, IL
  2. What 68530 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 68530 covers

This procedure clears obstructing material, such as a dacryolith, from the lacrimal drainage duct. Ophthalmologists, including oculoplastic surgeons, perform it for patients with tear drainage blockage that may cause persistent tearing or recurrent inflammation. The service concerns removal of the obstruction, rather than simple probing or placement of a drainage tube.

Report the code when the operative record supports actual clearance of obstructing material from the duct; document the site and what was removed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and 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.

How Chicago, IL compares for 68530

Across 109 of 109 payment localities, the office rate for 68530 runs from $386.20 in Arkansas to $576.67 in San Benito County, CA. Chicago, IL pays $448.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

68530 in Chicago, IL vs other payment areas
  1. Chicago, IL · this page$448.02
  2. East St. Louis, IL · Illinois$418.74−$29.28
  3. Rest of Illinois · Illinois$412.39−$35.63
  4. Suburban Chicago, IL · Illinois$449.81+$1.79
  5. Los Angeles, CA · California$490.91+$42.89
  6. Washington, DC area · District of Columbia$495.15+$47.13
  7. Miami, FL · Florida$460.29+$12.27

Other areas in Illinois first, then benchmark localities. Bars start at $0.

Every other payment area

68530 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$495.93$239.38
AlaskaAlaska$509.37$274.24
AlabamaAlabama$391.53$198.35
ArkansasArkansas$386.20$196.55
ArizonaArizona$422.78$208.85
Bakersfield, CACalifornia$461.32$219.35
Chico, CACalifornia$460.40$218.43
El Centro, CACalifornia$460.45$218.47

68530 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$386.20

$518.54

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
68530 office rate range by state
State / territoryOffice rate rangeLocalities
AK$509.371
AL$391.531
AR$386.201
AZ$422.781
CA$460.40–$576.6729
CO$452.371
CT$461.301
DC$495.151
DE$429.561
FL$424.89–$460.293
GA$402.55–$440.642
GU$471.201
HI$471.201
IA$402.101
ID$404.331
IL$412.39–$449.814
IN$406.571
KS$399.761
KY$399.051
LA$398.24–$416.902
MA$449.67–$496.362
MD$437.63–$495.153
ME$405.72–$427.362
MI$408.34–$429.332
MN$435.761
MO$391.40–$418.993
MS$388.901
MT$433.521
NC$409.831
ND$427.991
NE$404.351
NH$444.821
NJ$467.21–$490.352
NM$410.221
NV$432.291
NY$415.59–$506.665
OH$407.201
OK$398.971
OR$429.55–$466.782
PA$408.13–$449.972
PR$436.741
RI$444.841
SC$409.071
SD$427.331
TN$401.581
TX$405.55–$450.338
UT$414.371
VA$425.63–$495.152
VI$436.741
VT$425.891
WA$448.97–$506.782
WI$414.321
WV$397.801
WY$431.111

See 68530 in every payment locality

How the 68530 rate is calculated

Each of 68530’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 · 68530

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.61

3.61 RVUs× 1.000 GPCI

Practice expense9.09

9.09 RVUs× 1.000 GPCI

Malpractice0.28

0.28 RVUs× 1.000 GPCI

Adjusted RVUs

12.9800

Conversion factor

$33.4009

Medicare rate

$433.54

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Chicago, IL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,560

Code
68530
Physician work
3.61
Practice expense
9.09
Malpractice
0.28

GPCI2026.csv

48

Locality
Chicago, IL
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office calculation for 68530 in Chicago, IL
ComponentRVULocality factorAdjusted
Physician work3.61× 1.0073.6353
Practice expense9.09× 1.0059.1354
Malpractice0.28× 2.2950.6426
Total RVUs13.4133
Conversion factor× 33.4009

Office rate, Chicago, IL$448.02

Office: (3.61 × 1.007 + 9.09 × 1.005 + 0.28 × 2.295) × $33.4009 = $448.02

Facility: (3.61 × 1.007 + 2.48 × 1.005 + 0.28 × 2.295) × $33.4009 = $226.13

Open 68530 in the RVU calculator

Payment rules and modifiers for 68530

68530 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68530

Tear duct clearance, obstruction removal

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68530

Tear duct clearance, obstruction removal

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68530 without 50 · national office

$433.54

Tear duct clearance, obstruction removal

68530-50 · Bilateral: 150%

$650.31

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).

When to use modifier 50

Codes related to 68530

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 68530
CodeHow it relatesOffice range, Chicago, IL
Used instead
68810Tear duct probing, simple probingProbing, with or without irrigation, addresses duct patency without coding obstruction-material removal.$166.73
68815Duct probing, with tube or stentProbing with tube or stent insertion is the relevant choice when the service includes intubation.$384.18
68840Tear duct probing, lacrimal canaliculiProbing the lacrimal canaliculi addresses obstruction in a more proximal part of the drainage pathway.$138.91
68720Tear drainage surgery, no tube or stentDacryocystorhinostomy creates a drainage bypass rather than clearing obstructing material from the duct.No office rate

How 68530 has changed in Chicago, IL

68530 · Office / nonfacility

$448.02

Effective 2026-10-01

The base rate is $19.03 higher than on 2025-10-01, moving from $428.99 to $448.02 (4.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $428.99changed to$448.02

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.70 changed to 3.61
    • Practice expense RVU 8.75 changed to 9.09
    • Malpractice RVU 0.29 changed to 0.28
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $449.29changed to$428.99

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.96 changed to 8.75
    • Malpractice RVU 0.30 changed to 0.29

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $441.96changed to$449.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $458.92changed to$441.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.95 changed to 8.96
    • Malpractice RVU 0.29 changed to 0.30
    • Work GPCI 1.009 changed to 1.007
    • Practice expense GPCI 1.033 changed to 1.023
    • Malpractice GPCI 1.945 changed to 2.018

  5. January 1, 2023

    RVU23A

    $469.49changed to$458.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.91 changed to 8.95
    • Malpractice RVU 0.28 changed to 0.29
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 1.871 changed to 1.945

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $477.10changed to$469.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.03 changed to 8.91
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $465.14changed to$477.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.30 changed to 9.03
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.009 changed to 1.011
    • Practice expense GPCI 1.039 changed to 1.044
    • Malpractice GPCI 1.898 changed to 1.871

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $462.06changed to$465.14

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.29 changed to 8.30
    • Malpractice RVU 0.27 changed to 0.28
    • Work GPCI 1.008 changed to 1.009
    • Practice expense GPCI 1.034 changed to 1.039
    • Malpractice GPCI 1.925 changed to 1.898

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $458.95changed to$462.06

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.22 changed to 8.29

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $454.62changed to$458.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.08 changed to 8.22
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.012 changed to 1.008
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 1.972 changed to 1.925

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $455.21changed to$454.62

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.09 changed to 8.08
    • Work GPCI 1.016 changed to 1.012
    • Practice expense GPCI 1.037 changed to 1.036
    • Malpractice GPCI 2.019 changed to 1.972

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $456.48changed to$455.21

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.08 changed to 8.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $454.21changed to$456.48

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $486.90changed to$454.21

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.04 changed to 8.08
    • Malpractice RVU 0.69 changed to 0.28
    • Work GPCI 1.023 changed to 1.016
    • Practice expense GPCI 1.044 changed to 1.037
    • Malpractice GPCI 2.048 changed to 2.019

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $496.29changed to$486.90

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.83 changed to 8.04
    • Malpractice RVU 0.72 changed to 0.69
    • Work GPCI 1.030 changed to 1.023
    • Practice expense GPCI 1.051 changed to 1.044
    • Malpractice GPCI 2.077 changed to 2.048

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$496.29

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$448.02$226.13RVU26D
2026-07-01$448.02$226.13RVU26C
2026-04-01$448.02$226.13RVU26B
2026-01-01$448.02$226.13RVU26A
2025-10-01$428.99$257.25RVU25D
2025-07-01$428.99$257.25RVU25C
2025-04-01$428.99$257.25RVU25B
2025-01-01$428.99$257.25RVU25A
2024-10-01$449.29$264.39RVU24D
2024-07-01$449.29$264.39RVU24C
2024-04-01$449.29$264.39RVU24B
2024-03-09$449.29$264.39RVU24AR
2024-01-01$441.96$260.07RVU24A
2023-10-01$458.92$266.74RVU23D
2023-07-01$458.92$266.74RVU23C
2023-04-01$458.92$266.74RVU23B
2023-01-01$458.92$266.74RVU23A
2022-10-01$469.49$267.89RVU22D
2022-07-01$469.49$267.89RVU22C
2022-04-01$469.49$267.89RVU22B
2022-01-01$469.49$267.89RVU22A
2021-10-01$477.10$269.46RVU21D
2021-07-01$477.10$269.46RVU21C
2021-04-01$477.10$269.46RVU21B
2021-01-01$477.10$269.46RVU21A
2020-10-01$465.14$275.78RVU20D
2020-07-01$465.14$275.78RVU20C
2020-04-01$465.14$275.78RVU20B
2020-01-01$465.14$275.78RVU20A
2019-10-01$462.06$276.86RVU19D
2019-07-01$462.06$276.86RVU19C
2019-04-01$462.06$276.86RVU19B
2019-01-01$462.06$276.86RVU19A
2018-10-01$458.95$278.42RVU18D
2018-07-01$458.95$278.42RVU18C
2018-04-01$458.95$278.42RVU18B
2018-01-01$458.95$278.42RVU18AR1
2017-10-01$454.62$278.38RVU17D
2017-07-01$454.62$278.38RVU17C
2017-04-01$454.62$278.38RVU17B
2017-01-01$454.62$278.38RVU17A
2016-10-01$455.21$278.48RVU16D
2016-07-01$455.21$278.48RVU16C
2016-04-01$455.21$278.48RVU16B
2016-01-01$455.21$278.48RVU16A
2015-10-01$456.48$278.74RVU15D
2015-07-01$456.48$278.74RVU15C
2015-04-01$454.21$277.35RVU15B
2015-01-01$454.21$277.35RVU15A
2014-10-01$486.90$311.13RVU14D
2014-07-01$486.90$311.13RVU14C
2014-04-01$486.90$311.13RVU14B
2014-01-01$486.90$311.13RVU14A
2013-10-01$496.29$308.56RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 68530 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Illinois

68530 billing questions

When is this code more appropriate than probing the nasolacrimal duct?

Use 68530 when the service clears obstructing material from the lacrimal duct. Probing under 68810 describes probing, with or without irrigation, rather than removal of a concretion.

Does placing a lacrimal tube change the code choice?

When probing includes insertion of a tube or stent, compare the service with 68815. The operative documentation should show whether the work was obstruction removal or probing with intubation.

How should bilateral treatment be reported?

For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.

Are postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in the procedure payment.

Can an assistant surgeon or co-surgeon be reported?

CMS does not pay an assistant at surgery for this code, and 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
RVUs for 68530PPRRVU2026_Oct_nonQPP.csv, line 7,560 (RVU26D)
Geographic factors for Chicago, ILGPCI2026.csv, line 48 (RVU26D)

Open CMS sourceHow we calculate rates

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