CPT code 68816: Tear duct dilation, balloon catheter2026 Medicare rate & RVUs in Arizona
An ophthalmologist probes an obstructed nasolacrimal duct and dilates it with a balloon catheter to improve tear drainage.
In Arizona, Medicare pays $807.42 for 68816 in the office and $131.30 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 68816 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 68816 covers
This procedure treats obstruction or narrowing in the nasolacrimal duct, the passage that carries tears from the eye into the nose. The ophthalmologist passes a probe through the drainage pathway and uses a balloon catheter to expand the narrowed segment; irrigation may also be performed. It is commonly used for persistent tear-duct obstruction, including congenital obstruction in children, and may be performed in an operating room or another appropriate procedural setting.
Report this code when balloon catheter dilation is performed with probing, rather than probing alone or placement of a tube or stent. The operative note should identify the treated side, the obstruction or narrowing, and the probing and balloon-dilation work performed. The procedure has a 10-day global period, which includes related postoperative visits during that period. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 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 Arizona compares for 68816
Across 109 of 109 payment localities, the office rate for 68816 runs from $722.23 in Arkansas to $1,171.71 in San Benito County, CA. Arizona pays $807.42. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arizona · this page$807.42
- Los Angeles, CA · California$971.38+$163.96
- Washington, DC area · District of Columbia$970.88+$163.46
- Miami, FL · Florida$870.93+$63.51
- Chicago, IL · Illinois$842.87+$35.45
- Manhattan, NY · New York$961.97+$154.55
- Alaska · Alaska$912.78+$105.36
Other areas in Arizona first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $734.63 | $124.10 |
| ArkansasArkansas | $722.23 | $122.87 |
| Bakersfield, CACalifornia | $903.65 | $138.92 |
| Chico, CACalifornia | $903.12 | $138.39 |
| El Centro, CACalifornia | $903.15 | $138.42 |
| Fresno, CACalifornia | $903.12 | $138.39 |
| Hanford, CACalifornia | $903.12 | $138.39 |
| Madera, CACalifornia | $903.12 | $138.39 |
| Merced, CACalifornia | $903.12 | $138.39 |
| Modesto, CACalifornia | $903.12 | $138.39 |
| Napa, CACalifornia | $1,074.37 | $154.74 |
| Oxnard, CACalifornia | $969.52 | $144.78 |
| Redding, CACalifornia | $903.12 | $138.39 |
| Rest of CaliforniaCalifornia | $903.12 | $138.39 |
| Riverside, CACalifornia | $904.88 | $140.16 |
| Sacramento, CACalifornia | $955.20 | $143.72 |
| Salinas, CACalifornia | $951.83 | $143.14 |
| San Diego, CACalifornia | $979.83 | $145.33 |
| Marin County, CACalifornia | $1,146.02 | $162.20 |
| San Francisco, CACalifornia | $1,145.84 | $162.02 |
| San Benito County, CACalifornia | $1,171.71 | $165.56 |
| Santa Clara County, CACalifornia | $1,170.97 | $164.82 |
| San Luis Obispo, CACalifornia | $935.71 | $140.98 |
| Santa Cruz, CACalifornia | $993.58 | $145.82 |
| Santa Maria, CACalifornia | $956.93 | $143.36 |
| Santa Rosa, CACalifornia | $1,004.05 | $147.22 |
| Stockton, CACalifornia | $903.12 | $138.39 |
| Vallejo, CACalifornia | $1,074.11 | $154.48 |
| Visalia, CACalifornia | $903.12 | $138.39 |
| Yuba City, CACalifornia | $903.12 | $138.39 |
| ColoradoColorado | $879.84 | $137.44 |
| ConnecticutConnecticut | $892.53 | $141.06 |
| DelawareDelaware | $822.39 | $133.02 |
| Fort Lauderdale, FLFlorida | $845.85 | $139.04 |
| Rest of FloridaFlorida | $801.02 | $133.98 |
| Atlanta, GAGeorgia | $845.09 | $136.18 |
| Rest of GeorgiaGeorgia | $750.86 | $128.47 |
| Hawaii, Guam, HIHawaii | $933.26 | $139.92 |
| IowaIowa | $764.04 | $125.60 |
| IdahoIdaho | $768.24 | $126.31 |
| East St. Louis, ILIllinois | $776.47 | $134.55 |
| Rest of IllinoisIllinois | $768.76 | $131.72 |
| Suburban Chicago, ILIllinois | $856.75 | $140.17 |
| IndianaIndiana | $773.61 | $126.80 |
| KansasKansas | $756.28 | $125.52 |
| KentuckyKentucky | $747.10 | $126.81 |
| New Orleans, LALouisiana | $787.70 | $131.12 |
| Rest of LouisianaLouisiana | $744.30 | $126.80 |
| Metropolitan Boston, MAMassachusetts | $980.93 | $147.82 |
| Rest of MassachusettsMassachusetts | $871.86 | $137.13 |
| Baltimore area, MDMaryland | $889.37 | $140.69 |
| Rest of MarylandMaryland | $841.02 | $134.91 |
| Rest of MaineMaine | $769.03 | $127.11 |
| Southern Maine, MEMaine | $822.89 | $131.42 |
| Detroit, MIMichigan | $808.82 | $135.50 |
| Rest of MichiganMichigan | $766.44 | $129.40 |
| MinnesotaMinnesota | $849.90 | $131.92 |
| Metropolitan Kansas City, MOMissouri | $785.33 | $130.15 |
| Metropolitan St. Louis, MOMissouri | $795.32 | $131.06 |
| Rest of MissouriMissouri | $726.96 | $125.50 |
| MississippiMississippi | $724.94 | $124.19 |
| MontanaMontana | $831.67 | $133.93 |
| North CarolinaNorth Carolina | $778.98 | $127.98 |
| North DakotaNorth Dakota | $828.51 | $130.76 |
| NebraskaNebraska | $770.00 | $125.98 |
| New HampshireNew Hampshire | $862.09 | $135.73 |
| Northern New JerseyNew Jersey | $957.62 | $148.23 |
| Rest of New JerseyNew Jersey | $904.66 | $142.73 |
| New MexicoNew Mexico | $769.85 | $130.02 |
| NevadaNevada | $831.55 | $133.11 |
| NYC suburbs and Long Island, NYNew York | $983.88 | $154.26 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $907.88 | $143.85 |
| Queens, NYNew York | $976.36 | $151.62 |
| Rest of New YorkNew York | $792.20 | $129.34 |
| OhioOhio | $765.79 | $128.75 |
| OklahomaOklahoma | $749.40 | $126.31 |
| Portland, OROregon | $915.53 | $140.34 |
| Rest of OregonOregon | $827.06 | $132.11 |
| Metropolitan Philadelphia, PAPennsylvania | $865.02 | $138.67 |
| Rest of PennsylvaniaPennsylvania | $769.24 | $128.71 |
| Puerto RicoPuerto Rico | $839.94 | $134.52 |
| Rhode IslandRhode Island | $857.42 | $136.65 |
| South CarolinaSouth Carolina | $773.28 | $128.57 |
| South DakotaSouth Dakota | $828.13 | $130.39 |
| TennesseeTennessee | $760.24 | $125.99 |
| Austin, TXTexas | $875.17 | $136.95 |
| Beaumont, TXTexas | $763.09 | $128.15 |
| Brazoria, TXTexas | $824.23 | $132.77 |
| Dallas, TXTexas | $828.51 | $133.55 |
| Fort Worth, TXTexas | $821.00 | $133.02 |
| Galveston, TXTexas | $826.01 | $133.15 |
| Houston, TXTexas | $828.93 | $136.07 |
| Rest of TexasTexas | $792.51 | $130.35 |
| UtahUtah | $785.67 | $129.79 |
| VirginiaVirginia | $817.23 | $131.34 |
| Virgin Islands, VIUnited States Virgin Islands | $839.94 | $134.52 |
| VermontVermont | $821.46 | $130.70 |
| Rest of WashingtonWashington | $871.46 | $136.74 |
| King County, WAWashington | $1,006.16 | $150.03 |
| WisconsinWisconsin | $796.15 | $127.71 |
| West VirginiaWest Virginia | $734.71 | $128.37 |
| WyomingWyoming | $830.29 | $132.55 |
68816 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.
$722.23
$1,037.42
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $912.78 | 1 |
| AL | $734.63 | 1 |
| AR | $722.23 | 1 |
| AZ | $807.42 | 1 |
| CA | $903.12–$1,171.71 | 29 |
| CO | $879.84 | 1 |
| CT | $892.53 | 1 |
| DC | $970.88 | 1 |
| DE | $822.39 | 1 |
| FL | $801.02–$870.93 | 3 |
| GA | $750.86–$845.09 | 2 |
| GU | $933.26 | 1 |
| HI | $933.26 | 1 |
| IA | $764.04 | 1 |
| ID | $768.24 | 1 |
| IL | $768.76–$856.75 | 4 |
| IN | $773.61 | 1 |
| KS | $756.28 | 1 |
| KY | $747.10 | 1 |
| LA | $744.30–$787.70 | 2 |
| MA | $871.86–$980.93 | 2 |
| MD | $841.02–$970.88 | 3 |
| ME | $769.03–$822.89 | 2 |
| MI | $766.44–$808.82 | 2 |
| MN | $849.90 | 1 |
| MO | $726.96–$795.32 | 3 |
| MS | $724.94 | 1 |
| MT | $831.67 | 1 |
| NC | $778.98 | 1 |
| ND | $828.51 | 1 |
| NE | $770.00 | 1 |
| NH | $862.09 | 1 |
| NJ | $904.66–$957.62 | 2 |
| NM | $769.85 | 1 |
| NV | $831.55 | 1 |
| NY | $792.20–$983.88 | 5 |
| OH | $765.79 | 1 |
| OK | $749.40 | 1 |
| OR | $827.06–$915.53 | 2 |
| PA | $769.24–$865.02 | 2 |
| PR | $839.94 | 1 |
| RI | $857.42 | 1 |
| SC | $773.28 | 1 |
| SD | $828.13 | 1 |
| TN | $760.24 | 1 |
| TX | $763.09–$875.17 | 8 |
| UT | $785.67 | 1 |
| VA | $817.23–$970.88 | 2 |
| VI | $839.94 | 1 |
| VT | $821.46 | 1 |
| WA | $871.46–$1,006.16 | 2 |
| WI | $796.15 | 1 |
| WV | $734.71 | 1 |
| WY | $830.29 | 1 |
How the 68816 rate is calculated
Each of 68816’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 · 68816
RVUs × geographic indexes × conversion factor
Work2.05
2.05 RVUs× 1.000 GPCI
Practice expense22.69
22.69 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
24.9000
Conversion factor
$33.4009
Medicare rate
$831.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arizona inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,575
- Code
- 68816
- Physician work
- 2.05
- Practice expense
- 22.69
- Malpractice
- 0.16
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.05 | × 1.000 | 2.0500 |
| Practice expense | 22.69 | × 0.969 | 21.9866 |
| Malpractice | 0.16 | × 0.856 | 0.1370 |
| Total RVUs | 24.1736 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Arizona$807.42
Office: (2.05 × 1 + 22.69 × 0.969 + 0.16 × 0.856) × $33.4009 = $807.42
Facility: (2.05 × 1 + 1.8 × 0.969 + 0.16 × 0.856) × $33.4009 = $131.30
Payment rules and modifiers for 68816
68816 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68816
Tear duct dilation, balloon catheter
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68816
Tear duct dilation, balloon catheter
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.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68816 without 50 · national office
$831.68
Tear duct dilation, balloon catheter
68816-50 · Bilateral: 150%
$1,247.52
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).
How 68816 has changed in Arizona
68816 · Office / nonfacility
$807.42
Effective 2026-10-01
The base rate is $45.02 higher than on 2025-10-01, moving from $762.40 to $807.42 (5.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$762.40changed to$807.42
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.10 changed to 2.05
- Practice expense RVU 21.88 changed to 22.69
- Practice expense GPCI 0.975 changed to 0.969
- Malpractice GPCI 0.854 changed to 0.856
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$822.18changed to$762.40
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 23.03 changed to 21.88
- Malpractice RVU 0.17 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$808.76changed to$822.18
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$842.94changed to$808.76
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 23.49 changed to 23.03
- Malpractice RVU 0.18 changed to 0.17
- Practice expense GPCI 0.963 changed to 0.975
- Malpractice GPCI 0.855 changed to 0.854
January 1, 2023
RVU23A
$866.88changed to$842.94
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 23.97 changed to 23.49
- Practice expense GPCI 0.951 changed to 0.963
- Malpractice GPCI 0.857 changed to 0.855
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$850.90changed to$866.88
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 23.29 changed to 23.97
- Malpractice RVU 0.16 changed to 0.18
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$774.32changed to$850.90
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 20.00 changed to 23.29
- Practice expense GPCI 0.961 changed to 0.951
- Malpractice GPCI 0.846 changed to 0.857
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$718.78changed to$774.32
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 18.24 changed to 20.00
- Practice expense GPCI 0.971 changed to 0.961
- Malpractice GPCI 0.834 changed to 0.846
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$647.03changed to$718.78
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 16.21 changed to 18.24
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$644.34changed to$647.03
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 15.94 changed to 16.21
- Practice expense GPCI 0.986 changed to 0.971
- Malpractice GPCI 0.856 changed to 0.834
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$650.58changed to$644.34
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 15.93 changed to 15.94
- Practice expense GPCI 1.000 changed to 0.986
- Malpractice GPCI 0.877 changed to 0.856
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$749.99changed to$650.58
- Conversion factor 35.9335 changed to 35.8043
- Work RVU 3.06 changed to 2.10
- Practice expense RVU 17.61 changed to 15.93
- Malpractice RVU 0.23 changed to 0.16
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$746.26changed to$749.99
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$745.75changed to$746.26
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 17.41 changed to 17.61
- Malpractice RVU 0.57 changed to 0.23
- Practice expense GPCI 0.989 changed to 1.000
- Malpractice GPCI 0.946 changed to 0.877
Held through RVU15B.
January 1, 2014
RVU14A
$771.02changed to$745.75
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 19.42 changed to 17.41
- Malpractice RVU 0.60 changed to 0.57
- Practice expense GPCI 0.978 changed to 0.989
- Malpractice GPCI 1.015 changed to 0.946
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $771.02
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $807.42 | $131.30 | RVU26D |
| 2026-07-01 | $807.42 | $131.30 | RVU26C |
| 2026-04-01 | $807.42 | $131.30 | RVU26B |
| 2026-01-01 | $807.42 | $131.30 | RVU26A |
| 2025-10-01 | $762.40 | $148.35 | RVU25D |
| 2025-07-01 | $762.40 | $148.35 | RVU25C |
| 2025-04-01 | $762.40 | $148.35 | RVU25B |
| 2025-01-01 | $762.40 | $148.35 | RVU25A |
| 2024-10-01 | $822.18 | $152.63 | RVU24D |
| 2024-07-01 | $822.18 | $152.63 | RVU24C |
| 2024-04-01 | $822.18 | $152.63 | RVU24B |
| 2024-03-09 | $822.18 | $152.63 | RVU24AR |
| 2024-01-01 | $808.76 | $150.14 | RVU24A |
| 2023-10-01 | $842.94 | $153.07 | RVU23D |
| 2023-07-01 | $842.94 | $153.07 | RVU23C |
| 2023-04-01 | $842.94 | $153.07 | RVU23B |
| 2023-01-01 | $842.94 | $153.07 | RVU23A |
| 2022-10-01 | $866.88 | $152.72 | RVU22D |
| 2022-07-01 | $866.88 | $152.72 | RVU22C |
| 2022-04-01 | $866.88 | $152.72 | RVU22B |
| 2022-01-01 | $866.88 | $152.72 | RVU22A |
| 2021-10-01 | $850.90 | $153.05 | RVU21D |
| 2021-07-01 | $850.90 | $153.05 | RVU21C |
| 2021-04-01 | $850.90 | $153.05 | RVU21B |
| 2021-01-01 | $850.90 | $153.05 | RVU21A |
| 2020-10-01 | $774.32 | $156.63 | RVU20D |
| 2020-07-01 | $774.32 | $156.63 | RVU20C |
| 2020-04-01 | $774.32 | $156.63 | RVU20B |
| 2020-01-01 | $774.32 | $156.63 | RVU20A |
| 2019-10-01 | $718.78 | $158.53 | RVU19D |
| 2019-07-01 | $718.78 | $158.53 | RVU19C |
| 2019-04-01 | $718.78 | $158.53 | RVU19B |
| 2019-01-01 | $718.78 | $158.53 | RVU19A |
| 2018-10-01 | $647.03 | $158.70 | RVU18D |
| 2018-07-01 | $647.03 | $158.70 | RVU18C |
| 2018-04-01 | $647.03 | $158.70 | RVU18B |
| 2018-01-01 | $647.03 | $158.70 | RVU18AR1 |
| 2017-10-01 | $644.34 | $164.15 | RVU17D |
| 2017-07-01 | $644.34 | $164.15 | RVU17C |
| 2017-04-01 | $644.34 | $164.15 | RVU17B |
| 2017-01-01 | $644.34 | $164.15 | RVU17A |
| 2016-10-01 | $650.58 | $204.45 | RVU16D |
| 2016-07-01 | $650.58 | $204.45 | RVU16C |
| 2016-04-01 | $650.58 | $204.45 | RVU16B |
| 2016-01-01 | $650.58 | $204.45 | RVU16A |
| 2015-10-01 | $749.99 | $253.39 | RVU15D |
| 2015-07-01 | $749.99 | $253.39 | RVU15C |
| 2015-04-01 | $746.26 | $252.13 | RVU15B |
| 2015-01-01 | $746.26 | $252.13 | RVU15A |
| 2014-10-01 | $745.75 | $263.21 | RVU14D |
| 2014-07-01 | $745.75 | $263.21 | RVU14C |
| 2014-04-01 | $745.75 | $263.21 | RVU14B |
| 2014-01-01 | $745.75 | $263.21 | RVU14A |
| 2013-10-01 | $771.02 | $262.92 | RVU13D |
| 2013-07-01 | $771.02 | $262.92 | RVU13C |
| 2013-04-01 | $771.02 | $262.92 | RVU13B |
| 2013-01-01 | $771.02 | $262.92 | RVU13AR |
Where the Arizona rate applies
Arizona is a Medicare payment area, not a city. Our Census mapping connects it to 467 cities and communities in Arizona. Some span more than one payment area; confirm with the service ZIP.
- Aguila
- Ajo
- Ak Chin
- Ak-Chin Village
- Alamo Lake
- Ali Chuk
- Ali Chukson
- Ali Molina
68816 billing questions
When should I report this instead of 68810?
Use 68816 when the surgeon performs balloon catheter dilation along with probing. Probing without balloon dilation is reported with the applicable probing code.
How does 68816 differ from 68815?
68816 describes balloon catheter dilation with probing; 68815 is used when probing includes placement of a tube or stent. Select the code for the technique actually performed.
Can I report irrigation separately?
Irrigation may be performed as part of the probing service. Do not separately report a service solely for irrigation performed as part of this procedure.
How should bilateral treatment be reported?
For treatment of both nasolacrimal ducts, report modifier 50. CMS pays bilateral procedures at 150%.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be paid for this procedure?
CMS does not pay 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
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