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CPT code 68761: Punctal occlusion, plug, each punctum2026 Medicare rate & RVUs in Washington, DC area

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 Washington, DC area, Medicare pays $162.97 for 68761 in the office and $116.15 when it’s performed in a hospital or facility.

$162.97Office (non-facility)
$116.15Hospital or facility
+13.7%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 Washington, DC area
  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 Washington, DC area 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. Washington, DC area pays $162.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

68761 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$162.97
  2. Los Angeles, CA · California$161.80−$1.17
  3. Miami, FL · Florida$150.77−$12.20
  4. Chicago, IL · Illinois$147.11−$15.86
  5. Manhattan, NY · New York$163.01+$0.04
  6. Alaska · Alaska$171.31+$8.34
  7. Alabama · Alabama$130.38−$32.59

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

68761 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$128.73$94.59
ArizonaArizona$140.00$101.49
Bakersfield, CACalifornia$152.38$108.82
Chico, CACalifornia$152.12$108.56
El Centro, CACalifornia$152.13$108.57
Fresno, CACalifornia$152.12$108.56
Hanford, CACalifornia$152.12$108.56
Madera, CACalifornia$152.12$108.56

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 68761 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.37× 1.0541.4440
Practice expense2.85× 1.1783.3573
Malpractice0.07× 1.1130.0779
Total RVUs4.8792
Conversion factor× 33.4009

Office rate, Washington, DC area$162.97

Office: (1.37 × 1.054 + 2.85 × 1.178 + 0.07 × 1.113) × $33.4009 = $162.97

Facility: (1.37 × 1.054 + 1.66 × 1.178 + 0.07 × 1.113) × $33.4009 = $116.15

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, Washington, DC area
Used instead
68760Punctal closure, cautery or other methodCloses a punctum by a non-plug method, such as cauterization or ligation.$250.99

How 68761 has changed in Washington, DC area

68761 · Office / nonfacility

$162.97

Effective 2026-10-01

The base rate is $3.77 higher than on 2025-10-01, moving from $159.20 to $162.97 (2.4%).

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

    $159.20changed to$162.97

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $166.60changed to$159.20

    • 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

    $163.88changed to$166.60

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $171.45changed to$163.88

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.86 changed to 2.87
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $176.94changed to$171.45

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $179.70changed to$176.94

    • 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

    $176.50changed to$179.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.70 changed to 2.87
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $175.31changed to$176.50

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.72 changed to 2.70
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $175.56changed to$175.31

    • 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

    $172.60changed to$175.56

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.67 changed to 2.73
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $172.38changed to$172.60

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $173.00changed to$172.38

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $172.14changed to$173.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $176.21changed to$172.14

    • 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 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $177.80changed to$176.21

    • 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 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $177.80

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$162.97$116.15RVU26D
2026-07-01$162.97$116.15RVU26C
2026-04-01$162.97$116.15RVU26B
2026-01-01$162.97$116.15RVU26A
2025-10-01$159.20$128.35RVU25D
2025-07-01$159.20$128.35RVU25C
2025-04-01$159.20$128.35RVU25B
2025-01-01$159.20$128.35RVU25A
2024-10-01$166.60$132.08RVU24D
2024-07-01$166.60$132.08RVU24C
2024-04-01$166.60$132.08RVU24B
2024-03-09$166.60$132.08RVU24AR
2024-01-01$163.88$129.92RVU24A
2023-10-01$171.45$134.84RVU23D
2023-07-01$171.45$134.84RVU23C
2023-04-01$171.45$134.84RVU23B
2023-01-01$171.45$134.84RVU23A
2022-10-01$176.94$137.16RVU22D
2022-07-01$176.94$137.16RVU22C
2022-04-01$176.94$137.16RVU22B
2022-01-01$176.94$137.16RVU22A
2021-10-01$179.70$137.86RVU21D
2021-07-01$179.70$137.86RVU21C
2021-04-01$179.70$137.86RVU21B
2021-01-01$179.70$137.86RVU21A
2020-10-01$176.50$137.73RVU20D
2020-07-01$176.50$137.73RVU20C
2020-04-01$176.50$137.73RVU20B
2020-01-01$176.50$137.73RVU20A
2019-10-01$175.31$137.97RVU19D
2019-07-01$175.31$137.97RVU19C
2019-04-01$175.31$137.97RVU19B
2019-01-01$175.31$137.97RVU19A
2018-10-01$175.56$139.55RVU18D
2018-07-01$175.56$139.55RVU18C
2018-04-01$175.56$139.55RVU18B
2018-01-01$175.56$139.55RVU18AR1
2017-10-01$172.60$138.01RVU17D
2017-07-01$172.60$138.01RVU17C
2017-04-01$172.60$138.01RVU17B
2017-01-01$172.60$138.01RVU17A
2016-10-01$172.38$137.86RVU16D
2016-07-01$172.38$137.86RVU16C
2016-04-01$172.38$137.86RVU16B
2016-01-01$172.38$137.86RVU16A
2015-10-01$173.00$138.36RVU15D
2015-07-01$173.00$138.36RVU15C
2015-04-01$172.14$137.67RVU15B
2015-01-01$172.14$137.67RVU15A
2014-10-01$176.21$142.62RVU14D
2014-07-01$176.21$142.62RVU14C
2014-04-01$176.21$142.62RVU14B
2014-01-01$176.21$142.62RVU14A
2013-10-01$177.80$141.93RVU13D
2013-07-01$177.80$141.93RVU13C
2013-04-01$177.80$141.93RVU13B
2013-01-01$177.80$141.93RVU13AR

Price 68761 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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 Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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