CPT code 68720: Tear drainage surgery, no tube or stent2026 Medicare rate & RVUs in Napa, CA

Surgical creation of a drainage passage from the lacrimal sac into the nose treats tear outflow obstruction without tube or stent intubation.

CMS RVU26DEffective Oct 1, 2026One payment locality4.7K Medicare services in 2024

In Napa, CA, Medicare pays $821.34 for 68720 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$821.34Hospital or facility

Check a contract rate as a % of Medicare · 68720 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 68720 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Napa, CA
  2. What 68720 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 68720 covers

An ophthalmic surgeon creates a direct passage from the lacrimal sac into the nasal cavity to bypass an obstructed nasolacrimal duct. The operation is used for tear drainage problems such as persistent tearing or recurrent infection of the lacrimal sac. It is generally performed in an operating-room setting, including a hospital outpatient department or ambulatory surgery center. This code describes the DCR without tube or stent intubation.

The operative report should support the lacrimal sac-to-nose bypass, identify the treated side, and clarify whether a tube or stent was inserted. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 Napa, CA compares for 68720

Across 109 of 109 payment localities, the facility rate for 68720 runs from $639.97 in Arkansas to $880.88 in San Benito County, CA. Napa, CA pays $821.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

68720 in Napa, CA vs other payment areas
  1. Napa, CA · this page$821.34
  2. Bakersfield, CA · California$731.91−$89.43
  3. Chico, CA · California$729.26−$92.08
  4. El Centro, CA · California$729.40−$91.94
  5. Fresno, CA · California$729.26−$92.08
  6. Hanford, CA · California$729.26−$92.08
  7. Los Angeles, CA · California$771.09−$50.25

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

Every other payment area

68720 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia—$729.26
Merced, CACalifornia—$729.26
Modesto, CACalifornia—$729.26
Oxnard, CACalifornia—$765.40
Redding, CACalifornia—$729.26
Rest of CaliforniaCalifornia—$729.26
Riverside, CACalifornia—$738.27
Sacramento, CACalifornia—$758.94

68720 rates by state

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

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.

View every state and territory as a table
68720 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 68720 in every payment locality

How the 68720 rate is calculated

Each of 68720’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 · 68720

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.71

9.71 RVUs× 1.000 GPCI

Practice expense10.51

10.51 RVUs× 1.000 GPCI

Malpractice0.82

0.82 RVUs× 1.000 GPCI

Adjusted RVUs

21.0400

Conversion factor

$33.4009

Medicare rate

$702.75

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

The exact Napa, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,565

Code
68720
Physician work
9.71
Practice expense
10.51
Malpractice
0.82

GPCI2026.csv

17

Locality
Napa, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.508
Facility calculation for 68720 in Napa, CA
ComponentRVULocality factorAdjusted
Physician work9.71× 1.06310.3217
Practice expense10.51× 1.31813.8522
Malpractice0.82× 0.5080.4166
Total RVUs24.5905
Conversion factor× 33.4009

Facility rate, Napa, CA$821.34

Facility: (9.71 × 1.063 + 10.51 × 1.318 + 0.82 × 0.508) × $33.4009 = $821.34

Open 68720 in the RVU calculator

Payment rules and modifiers for 68720

68720 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68720

Tear drainage surgery, no tube or stent

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68720

Tear drainage surgery, no tube or stent

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68720 without 50 · national facility

$702.75

Tear drainage surgery, no tube or stent

68720-50 · Bilateral: 150%

$1,054.13

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

How 68720 has changed in Napa, CA

68720 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$821.34RVU26D
2026-07-01Not available in this setting$821.34RVU26C
2026-04-01Not available in this setting$821.34RVU26B
2026-01-01Not available in this setting$821.34RVU26A
2025-10-01Not available in this setting$916.55RVU25D
2025-07-01Not available in this setting$916.55RVU25C
2025-04-01Not available in this setting$916.55RVU25B
2025-01-01Not available in this setting$916.55RVU25A
2024-10-01Not available in this setting$947.58RVU24D
2024-07-01Not available in this setting$947.58RVU24C
2024-04-01Not available in this setting$947.58RVU24B
2024-03-09Not available in this setting$947.58RVU24AR
2024-01-01Not available in this setting$932.11RVU24A
2023-10-01Not available in this setting$936.20RVU23D
2023-07-01Not available in this setting$936.20RVU23C
2023-04-01Not available in this setting$936.20RVU23B
2023-01-01Not available in this setting$936.20RVU23A
2022-10-01Not available in this setting$921.63RVU22D
2022-07-01Not available in this setting$921.63RVU22C
2022-04-01Not available in this setting$921.63RVU22B
2022-01-01Not available in this setting$921.63RVU22A
2021-10-01Not available in this setting$907.64RVU21D
2021-07-01Not available in this setting$907.64RVU21C
2021-04-01Not available in this setting$907.64RVU21B
2021-01-01Not available in this setting$907.64RVU21A
2020-10-01Not available in this setting$899.65RVU20D
2020-07-01Not available in this setting$899.65RVU20C
2020-04-01Not available in this setting$899.65RVU20B
2020-01-01Not available in this setting$899.65RVU20A
2019-10-01Not available in this setting$883.43RVU19D
2019-07-01Not available in this setting$883.43RVU19C
2019-04-01Not available in this setting$883.43RVU19B
2019-01-01Not available in this setting$883.43RVU19A
2018-10-01Not available in this setting$881.11RVU18D
2018-07-01Not available in this setting$881.11RVU18C
2018-04-01Not available in this setting$881.11RVU18B
2018-01-01Not available in this setting$881.11RVU18AR1
2017-10-01Not available in this setting$880.74RVU17D
2017-07-01Not available in this setting$880.74RVU17C
2017-04-01Not available in this setting$880.74RVU17B
2017-01-01Not available in this setting$880.74RVU17A
2016-10-01Not available in this settingRate data unavailableRVU16D
2016-07-01Not available in this settingRate data unavailableRVU16C
2016-04-01Not available in this settingRate data unavailableRVU16B
2016-01-01Not available in this settingRate data unavailableRVU16A
2015-10-01Not available in this settingRate data unavailableRVU15D
2015-07-01Not available in this settingRate data unavailableRVU15C
2015-04-01Not available in this settingRate data unavailableRVU15B
2015-01-01Not available in this settingRate data unavailableRVU15A
2014-10-01Not available in this settingRate data unavailableRVU14D
2014-07-01Not available in this settingRate data unavailableRVU14C
2014-04-01Not available in this settingRate data unavailableRVU14B
2014-01-01Not available in this settingRate data unavailableRVU14A
2013-10-01Not available in this settingRate data unavailableRVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 68720 for an earlier date of service

Where the Napa, CA rate applies

Napa, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Napa
  • American Canyon
  • Angwin
  • Calistoga
  • Deer Park
  • Moskowite Corner
  • Oakville
  • Rutherford

Browse all communities in California

68720 billing questions

How is this code distinguished from a DCR with intubation?

Report 68720 when the DCR is performed without a tube or stent. A DCR that includes tube or stent insertion is represented by 68745.

Can the tube or stent be billed separately with 68720?

This code represents a DCR without intubation. If a tube or stent is inserted as part of the DCR, use the applicable DCR code for that service rather than treating the implant as a separate 68720 service.

What documentation supports reporting 68720?

The operative report should describe creation of the lacrimal sac-to-nasal passage, the clinical obstruction being bypassed, the side treated, and whether intubation was performed.

How is bilateral DCR reported?

For bilateral procedures, report modifier 50; CMS payment for the bilateral procedure is 150%.

Are related postoperative visits included?

Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided.

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 68720PPRRVU2026_Oct_nonQPP.csv, line 7,565 (RVU26D)
Geographic factors for Napa, CAGPCI2026.csv, line 17 (RVU26D)

Open CMS sourceHow we calculate rates

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