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CPT code 68705: Punctum revision, with reconstruction2026 Medicare rate & RVUs in King County, WA

Reconstructs a narrowed or abnormal lacrimal punctum to improve tear drainage, with dilation included when performed as part of the repair.

CMS RVU26DEffective Oct 1, 2026One payment locality518 Medicare services in 2024

In King County, WA, Medicare pays $304.34 for 68705 in the office and $161.31 when it’s performed in a hospital or facility.

$304.34Office (non-facility)
$161.31Hospital or facility
+17.1%vs the national office rate ($259.86)

Check a contract rate as a % of Medicare · 68705 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 68705 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 68705 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 68705 covers

This procedure revises and reconstructs the lacrimal punctum, the small opening at the inner eyelid that drains tears. Ophthalmologists, including oculoplastic surgeons, may perform it for a narrowed or abnormal punctum associated with impaired tear drainage, such as persistent tearing. It may be performed in an office or an operating room, depending on the clinical circumstances and the extent of repair.

Report the code when the service involves reconstruction of the punctum; dilation performed as part of that service is included. Documentation should identify the affected side, the punctal abnormality, and the reconstruction performed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. For bilateral services, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Assistant-at-surgery payment is restricted; 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 King County, WA compares for 68705

Across 109 of 109 payment localities, the office rate for 68705 runs from $230.97 in Arkansas to $346.73 in San Benito County, CA. King County, WA pays $304.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

68705 in King County, WA vs other payment areas
  1. King County, WA · this page$304.34
  2. Rest of Washington · Washington$269.22−$35.12
  3. Los Angeles, CA · California$294.70−$9.64
  4. Washington, DC area · District of Columbia$297.21−$7.13
  5. Miami, FL · Florida$276.14−$28.20
  6. Chicago, IL · Illinois$268.62−$35.72
  7. Manhattan, NY · New York$297.62−$6.72

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

Every other payment area

68705 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$303.76$179.62
AlabamaAlabama$234.22$132.22
ArkansasArkansas$230.97$130.83
ArizonaArizona$253.29$140.34
Bakersfield, CACalifornia$276.74$148.98
Chico, CACalifornia$276.19$148.43
El Centro, CACalifornia$276.22$148.46
Fresno, CACalifornia$276.19$148.43

68705 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.

$230.97

$311.46

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

View every state and territory as a table
68705 office rate range by state
State / territoryOffice rate rangeLocalities
AK$303.761
AL$234.221
AR$230.971
AZ$253.291
CA$276.19–$346.7329
CO$271.311
CT$276.701
DC$297.211
DE$257.411
FL$254.56–$276.143
GA$240.93–$264.172
GU$282.861
HI$282.861
IA$240.681
ID$242.041
IL$246.93–$269.734
IN$243.411
KS$239.251
KY$238.801
LA$238.30–$249.692
MA$269.63–$298.022
MD$262.31–$297.213
ME$242.88–$256.102
MI$244.46–$257.272
MN$261.241
MO$234.13–$250.973
MS$232.611
MT$259.851
NC$245.391
ND$256.491
NE$242.051
NH$266.751
NJ$280.22–$294.242
NM$245.611
NV$259.101
NY$248.90–$304.165
OH$243.781
OK$238.761
OR$257.43–$280.082
PA$244.35–$269.792
PR$261.811
RI$266.671
SC$244.921
SD$256.091
TN$240.361
TX$242.77–$270.108
UT$248.161
VA$255.04–$297.212
VI$261.811
VT$255.201
WA$269.22–$304.342
WI$248.141
WV$238.021
WY$258.381

See 68705 in every payment locality

How the 68705 rate is calculated

Each of 68705’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 · 68705

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense5.55

5.55 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

7.7800

Conversion factor

$33.4009

Medicare rate

$259.86

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

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,564

Code
68705
Physician work
2.06
Practice expense
5.55
Malpractice
0.17

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 68705 in King County, WA
ComponentRVULocality factorAdjusted
Physician work2.06× 1.0502.1630
Practice expense5.55× 1.2276.8098
Malpractice0.17× 0.8170.1389
Total RVUs9.1117
Conversion factor× 33.4009

Office rate, King County, WA$304.34

Office: (2.06 × 1.05 + 5.55 × 1.227 + 0.17 × 0.817) × $33.4009 = $304.34

Facility: (2.06 × 1.05 + 2.06 × 1.227 + 0.17 × 0.817) × $33.4009 = $161.31

Open 68705 in the RVU calculator

Payment rules and modifiers for 68705

68705 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68705

Punctum revision, with reconstruction

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 · 68705

Punctum revision, with reconstruction

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

68705 without 50 · national office

$259.86

Punctum revision, with reconstruction

68705-50 · Bilateral: 150%

$389.79

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 68705

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

Codes related to 68705
CodeHow it relatesOffice range, King County, WA
Used instead
68801Punctum dilation, punctal opening, with or without irrigationReports dilation of the lacrimal punctum without reconstruction.$110.57
68700Canaliculus repair, tear drainage channelRepairs the lacrimal canaliculus when the problem involves that drainage structure rather than the punctum.No office rate
68720Tear drainage surgery, no tube or stentCreates a drainage route for obstruction farther downstream in the lacrimal system.No office rate

How 68705 has changed in King County, WA

68705 · Office / nonfacility

$304.34

Effective 2026-10-01

The base rate is $16.43 higher than on 2025-10-01, moving from $287.91 to $304.34 (5.7%).

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

    $287.91changed to$304.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.11 changed to 2.06
    • Practice expense RVU 5.38 changed to 5.55
    • Malpractice RVU 0.16 changed to 0.17
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $302.66changed to$287.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.53 changed to 5.38
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $297.72changed to$302.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $306.27changed to$297.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.55 changed to 5.53
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $308.98changed to$306.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.53 changed to 5.55
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $307.25changed to$308.98

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.44 changed to 5.53
    • Malpractice RVU 0.16 changed to 0.18

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $291.19changed to$307.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.92 changed to 5.44
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $278.40changed to$291.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.72 changed to 4.92
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $269.02changed to$278.40

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.50 changed to 4.72

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $263.96changed to$269.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.41 changed to 4.50
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $262.23changed to$263.96

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.40 changed to 4.41
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $262.76changed to$262.23

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.39 changed to 4.40

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $261.45changed to$262.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $267.53changed to$261.45

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.38 changed to 4.39
    • Malpractice RVU 0.39 changed to 0.16
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $273.48changed to$267.53

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.82 changed to 4.38
    • Malpractice RVU 0.41 changed to 0.39
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $273.48

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$304.34$161.31RVU26D
2026-07-01$304.34$161.31RVU26C
2026-04-01$304.34$161.31RVU26B
2026-01-01$304.34$161.31RVU26A
2025-10-01$287.91$180.57RVU25D
2025-07-01$287.91$180.57RVU25C
2025-04-01$287.91$180.57RVU25B
2025-01-01$287.91$180.57RVU25A
2024-10-01$302.66$185.70RVU24D
2024-07-01$302.66$185.70RVU24C
2024-04-01$302.66$185.70RVU24B
2024-03-09$302.66$185.70RVU24AR
2024-01-01$297.72$182.67RVU24A
2023-10-01$306.27$185.20RVU23D
2023-07-01$306.27$185.20RVU23C
2023-04-01$306.27$185.20RVU23B
2023-01-01$306.27$185.20RVU23A
2022-10-01$308.98$183.78RVU22D
2022-07-01$308.98$183.78RVU22C
2022-04-01$308.98$183.78RVU22B
2022-01-01$308.98$183.78RVU22A
2021-10-01$307.25$184.35RVU21D
2021-07-01$307.25$184.35RVU21C
2021-04-01$307.25$184.35RVU21B
2021-01-01$307.25$184.35RVU21A
2020-10-01$291.19$185.20RVU20D
2020-07-01$291.19$185.20RVU20C
2020-04-01$291.19$185.20RVU20B
2020-01-01$291.19$185.20RVU20A
2019-10-01$278.40$184.65RVU19D
2019-07-01$278.40$184.65RVU19C
2019-04-01$278.40$184.65RVU19B
2019-01-01$278.40$184.65RVU19A
2018-10-01$269.02$185.27RVU18D
2018-07-01$269.02$185.27RVU18C
2018-04-01$269.02$185.27RVU18B
2018-01-01$269.02$185.27RVU18AR1
2017-10-01$263.96$182.99RVU17D
2017-07-01$263.96$182.99RVU17C
2017-04-01$263.96$182.99RVU17B
2017-01-01$263.96$182.99RVU17A
2016-10-01$262.23$181.59RVU16D
2016-07-01$262.23$181.59RVU16C
2016-04-01$262.23$181.59RVU16B
2016-01-01$262.23$181.59RVU16A
2015-10-01$262.76$182.24RVU15D
2015-07-01$262.76$182.24RVU15C
2015-04-01$261.45$181.34RVU15B
2015-01-01$261.45$181.34RVU15A
2014-10-01$267.53$187.61RVU14D
2014-07-01$267.53$187.61RVU14C
2014-04-01$267.53$187.61RVU14B
2014-01-01$267.53$187.61RVU14A
2013-10-01$273.48$189.41RVU13D
2013-07-01$273.48$189.41RVU13C
2013-04-01$273.48$189.41RVU13B
2013-01-01$273.48$189.41RVU13AR

Price 68705 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 68705 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

68705 billing questions

When should 68705 be chosen instead of punctal dilation?

Use 68705 when the punctum is reconstructed, with or without dilation. Simple dilation without reconstruction is reported with 68801.

Can dilation be billed separately with 68705?

Dilation performed as part of the punctal reconstruction is included in 68705. The code covers reconstruction whether or not dilation is performed.

How is a bilateral punctal reconstruction reported?

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

Are postoperative visits separately payable during the global period?

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

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay for 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 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 68705PPRRVU2026_Oct_nonQPP.csv, line 7,564 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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