CPT code 68840: Tear duct probing, lacrimal canaliculi2026 Medicare rate & RVUs in Guam
Probing the lacrimal canaliculi, with or without irrigation, evaluates or treats a blockage in the small tear-drainage channels near the eyelid.
Medicare pays $145.18 for 68840 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 68840 covers
An ophthalmologist, often an oculoplastic surgeon, passes a probe through the lacrimal punctum into a canaliculus to assess or relieve an obstruction. Irrigation may be performed as part of the service. The procedure is used for problems such as tearing associated with suspected canalicular narrowing or blockage, and may be performed in an office procedure room or an operating room depending on the patient and clinical circumstances.
Report 68840 when the treated structure is a lacrimal canaliculus, rather than the nasolacrimal duct. Document the affected side, the clinical indication, and the probing performed; irrigation does not require a separate code. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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.
68840 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $145.18 | $111.38 |
How the 68840 rate is calculated
Each of 68840’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 · 68840
RVUs × geographic indexes × conversion factor
Work1.27
1.27 RVUs× 1.000 GPCI
Practice expense2.66
2.66 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
4.0200
Conversion factor
$33.4009
Medicare rate
$134.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 68840
68840 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68840
Tear duct probing, lacrimal canaliculi
| 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 · 68840
Tear duct probing, lacrimal canaliculi
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
68840 without 50 · national office
$134.27
Tear duct probing, lacrimal canaliculi
68840-50 · Bilateral: 150%
$201.41
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).
68840 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 68801Punctum dilationPunctal opening, with or without irrigation
- Use 68801 for dilation of the lacrimal punctum. Use 68840 when the procedure probes the canaliculus beyond the punctal opening.
- 68810Tear duct probingSimple probing
- Code 68810 addresses probing of the nasolacrimal duct; 68840 addresses probing of the lacrimal canaliculi.
- 68811Tear duct probingGeneral anesthesia
- Code 68811 is for nasolacrimal duct probing requiring general anesthesia. It is not the canalicular probing service reported with 68840.
- 68815Duct probingWith tube or stent
- Code 68815 includes insertion of a tube or stent during nasolacrimal duct probing. Code 68840 describes canalicular probing without that duct-stenting service.
68840 billing questions
When should 68840 be chosen over 68810?
Use 68840 when probing the lacrimal canaliculi. Code 68810 is for probing the nasolacrimal duct, a different part of the tear-drainage pathway.
Is irrigation separately reported with 68840?
No. Irrigation may be part of the canalicular probing service and is not separately reported as an additional service under this code.
How is bilateral canalicular probing reported?
Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150% of the single-side amount.
Are related postoperative visits included?
Yes. The 10-day global period includes related postoperative visits during those 10 days.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted 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
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