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CPT code 68761: Punctal occlusion, plug, each punctum2026 Medicare rate & RVUs in Los Angeles, CA

Reports plug-based closure of a lacrimal punctum, commonly to retain tears in patients with aqueous-deficient dry eye.

CMS RVU26DEffective Oct 1, 2026One payment locality508.4K Medicare services in 2024

In Los Angeles, CA, Medicare pays $161.80 for 68761 in the office and $114.78 when it’s performed in a hospital or facility.

$161.80Office (non-facility)
$114.78Hospital or facility
+12.9%vs the national office rate ($143.29)

Check a contract rate as a % of Medicare · 68761 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 68761 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Los Angeles, CA
  2. What 68761 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 68761 covers

An ophthalmologist places a plug in a lacrimal punctum to reduce tear drainage and help retain the eye’s natural tears. This is commonly performed in an office for patients with dry eye related to inadequate tear volume. The code represents treatment of each punctum, rather than a permanent closure technique or surgery to restore tear drainage.

Report the code for each punctum treated and document the indication, site and number of puncta, and plug placement. For bilateral treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%. A 10-day global period includes related postoperative visits during that period. If multiple procedures subject to the standard multiple-procedure rule are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documentation of medical necessity; 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 Los Angeles, CA compares for 68761

Across 109 of 109 payment localities, the office rate for 68761 runs from $128.73 in Arkansas to $189.31 in San Benito County, CA. Los Angeles, CA pays $161.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

68761 in Los Angeles, CA vs other payment areas
  1. Los Angeles, CA · this page$161.80
  2. Bakersfield, CA · California$152.38−$9.42
  3. Chico, CA · California$152.12−$9.68
  4. El Centro, CA · California$152.13−$9.67
  5. Fresno, CA · California$152.12−$9.68
  6. Hanford, CA · California$152.12−$9.68
  7. Madera, CA · California$152.12−$9.68

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

Every other payment area

68761 in every other Medicare payment locality
Payment localityOfficeFacility
Merced, CACalifornia$152.12$108.56
Modesto, CACalifornia$152.12$108.56
Napa, CACalifornia$175.29$122.91
Oxnard, CACalifornia$161.01$114.03
Redding, CACalifornia$152.12$108.56
Rest of CaliforniaCalifornia$152.12$108.56
Riverside, CACalifornia$152.91$109.35
Sacramento, CACalifornia$159.37$113.14

68761 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.

$128.73

$171.31

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

View every state and territory as a table
68761 office rate range by state
State / territoryOffice rate rangeLocalities
AK$171.311
AL$130.381
AR$128.731
AZ$140.001
CA$152.12–$189.3129
CO$149.421
CT$152.031
DC$162.971
DE$142.141
FL$140.28–$150.773
GA$133.46–$145.422
GU$155.351
HI$155.351
IA$133.791
ID$134.441
IL$136.32–$147.994
IN$135.141
KS$132.991
KY$132.521
LA$132.24–$137.992
MA$148.59–$163.382
MD$144.70–$162.973
ME$134.79–$141.572
MI$135.31–$141.562
MN$144.401
MO$130.09–$138.733
MS$129.451
MT$143.291
NC$136.071
ND$141.901
NE$134.511
NH$146.901
NJ$154.10–$161.562
NM$135.861
NV$142.991
NY$137.84–$166.215
OH$135.031
OK$132.581
OR$142.21–$153.992
PA$135.36–$148.472
PR$144.301
RI$147.051
SC$135.701
SD$141.741
TN$133.541
TX$134.56–$148.648
UT$137.341
VA$140.98–$162.972
VI$144.301
VT$141.181
WA$148.37–$166.762
WI$137.671
WV$131.831
WY$142.681

See 68761 in every payment locality

How the 68761 rate is calculated

Each of 68761’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 · 68761

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.37

1.37 RVUs× 1.000 GPCI

Practice expense2.85

2.85 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

4.2900

Conversion factor

$33.4009

Medicare rate

$143.29

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

The exact Los Angeles, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,569

Code
68761
Physician work
1.37
Practice expense
2.85
Malpractice
0.07

GPCI2026.csv

13

Locality
Los Angeles, CA
Physician work
1.041
Practice expense
1.183
Malpractice
0.664
Office calculation for 68761 in Los Angeles, CA
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0411.4262
Practice expense2.85× 1.1833.3716
Malpractice0.07× 0.6640.0465
Total RVUs4.8442
Conversion factor× 33.4009

Office rate, Los Angeles, CA$161.80

Office: (1.37 × 1.041 + 2.85 × 1.183 + 0.07 × 0.664) × $33.4009 = $161.80

Facility: (1.37 × 1.041 + 1.66 × 1.183 + 0.07 × 0.664) × $33.4009 = $114.78

Open 68761 in the RVU calculator

Payment rules and modifiers for 68761

68761 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68761

Punctal occlusion, plug, each punctum

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)0Not paid without supporting documentation.
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 · 68761

Punctal occlusion, plug, each punctum

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

68761 without 50 · national office

$143.29

Punctal occlusion, plug, each punctum

68761-50 · Bilateral: 150%

$214.94

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 68761

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

Codes related to 68761
CodeHow it relatesOffice range, Los Angeles, CA
Used instead
68760Punctal closure, cautery or other methodCloses a punctum by a non-plug method, such as cauterization or ligation.$248.92

How 68761 has changed in Los Angeles, CA

68761 · Office / nonfacility

$161.80

Effective 2026-10-01

The base rate is $4.19 higher than on 2025-10-01, moving from $157.61 to $161.80 (2.7%).

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

    $157.61changed to$161.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.41 changed to 1.37
    • Practice expense RVU 2.81 changed to 2.85
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.194 changed to 1.183
    • Malpractice GPCI 0.690 changed to 0.664

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $164.81changed to$157.61

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.87 changed to 2.81
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $162.12changed to$164.81

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $166.74changed to$162.12

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.86 changed to 2.87
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.185 changed to 1.194
    • Malpractice GPCI 0.724 changed to 0.690

  5. January 1, 2023

    RVU23A

    $168.98changed to$166.74

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.84 changed to 2.86
    • Malpractice RVU 0.09 changed to 0.08
    • Work GPCI 1.048 changed to 1.045
    • Practice expense GPCI 1.175 changed to 1.185
    • Malpractice GPCI 0.757 changed to 0.724

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $171.61changed to$168.98

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.87 changed to 2.84

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $170.22changed to$171.61

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.70 changed to 2.87
    • Work GPCI 1.047 changed to 1.048
    • Practice expense GPCI 1.176 changed to 1.175
    • Malpractice GPCI 0.725 changed to 0.757

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $170.78changed to$170.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.72 changed to 2.70
    • Work GPCI 1.046 changed to 1.047
    • Practice expense GPCI 1.177 changed to 1.176
    • Malpractice GPCI 0.694 changed to 0.725

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $171.02changed to$170.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.73 changed to 2.72

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $167.59changed to$171.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.67 changed to 2.73
    • Work GPCI 1.047 changed to 1.046
    • Practice expense GPCI 1.169 changed to 1.177
    • Malpractice GPCI 0.801 changed to 0.694

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $166.77changed to$167.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.161 changed to 1.169
    • Malpractice GPCI 0.908 changed to 0.801

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $167.37changed to$166.77

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $166.54changed to$167.37

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $168.39changed to$166.54

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.65 changed to 2.67
    • Malpractice RVU 0.21 changed to 0.09
    • Work GPCI 1.042 changed to 1.047
    • Practice expense GPCI 1.158 changed to 1.161
    • Malpractice GPCI 0.775 changed to 0.908

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $169.15changed to$168.39

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.92 changed to 2.65
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.036 changed to 1.042
    • Practice expense GPCI 1.154 changed to 1.158
    • Malpractice GPCI 0.642 changed to 0.775

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$169.15

  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$161.80$114.78RVU26D
2026-07-01$161.80$114.78RVU26C
2026-04-01$161.80$114.78RVU26B
2026-01-01$161.80$114.78RVU26A
2025-10-01$157.61$126.72RVU25D
2025-07-01$157.61$126.72RVU25C
2025-04-01$157.61$126.72RVU25B
2025-01-01$157.61$126.72RVU25A
2024-10-01$164.81$130.23RVU24D
2024-07-01$164.81$130.23RVU24C
2024-04-01$164.81$130.23RVU24B
2024-03-09$164.81$130.23RVU24AR
2024-01-01$162.12$128.11RVU24A
2023-10-01$166.74$131.00RVU23D
2023-07-01$166.74$131.00RVU23C
2023-04-01$166.74$131.00RVU23B
2023-01-01$166.74$131.00RVU23A
2022-10-01$168.98$131.16RVU22D
2022-07-01$168.98$131.16RVU22C
2022-04-01$168.98$131.16RVU22B
2022-01-01$168.98$131.16RVU22A
2021-10-01$171.61$131.84RVU21D
2021-07-01$171.61$131.84RVU21C
2021-04-01$171.61$131.84RVU21B
2021-01-01$171.61$131.84RVU21A
2020-10-01$170.22$132.88RVU20D
2020-07-01$170.22$132.88RVU20C
2020-04-01$170.22$132.88RVU20B
2020-01-01$170.22$132.88RVU20A
2019-10-01$170.78$134.30RVU19D
2019-07-01$170.78$134.30RVU19C
2019-04-01$170.78$134.30RVU19B
2019-01-01$170.78$134.30RVU19A
2018-10-01$171.02$135.85RVU18D
2018-07-01$171.02$135.85RVU18C
2018-04-01$171.02$135.85RVU18B
2018-01-01$171.02$135.85RVU18AR1
2017-10-01$167.59$134.02RVU17D
2017-07-01$167.59$134.02RVU17C
2017-04-01$167.59$134.02RVU17B
2017-01-01$167.59$134.02RVU17A
2016-10-01$166.77$133.52RVU16D
2016-07-01$166.77$133.52RVU16C
2016-04-01$166.77$133.52RVU16B
2016-01-01$166.77$133.52RVU16A
2015-10-01$167.37$134.00RVU15D
2015-07-01$167.37$134.00RVU15C
2015-04-01$166.54$133.33RVU15B
2015-01-01$166.54$133.33RVU15A
2014-10-01$168.39$136.03RVU14D
2014-07-01$168.39$136.03RVU14C
2014-04-01$168.39$136.03RVU14B
2014-01-01$168.39$136.03RVU14A
2013-10-01$169.15$134.60RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 68761 for an earlier date of service

Where the Los Angeles, CA rate applies

Los Angeles, CA is a Medicare payment area, not a city. Our Census mapping connects it to 189 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Anaheim
  • Long Beach
  • Los Angeles
  • Orange
  • Acton
  • Agoura Hills
  • Agua Dulce
  • Alhambra

Browse all communities in California

68761 billing questions

How does this differ from 68760?

This code is for plug-based punctal closure. Code 68760 is used when the punctum is closed by a method such as cauterization or ligation.

How many units should be reported?

The code represents each punctum treated. Document the punctum or puncta where plugs were placed.

How is bilateral treatment reported?

Use modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.

Are related postoperative visits separately payable?

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

What documentation supports reporting this service?

Document the tear-retention indication, the treated punctum or puncta, and that plug placement was performed.

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 68761PPRRVU2026_Oct_nonQPP.csv, line 7,569 (RVU26D)
Geographic factors for Los Angeles, CAGPCI2026.csv, line 13 (RVU26D)

Open CMS sourceHow we calculate rates

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