CPT code 68840: Tear duct probing, lacrimal canaliculi2026 Medicare rate & RVUs in Nevada

Probing the lacrimal canaliculi, with or without irrigation, evaluates or treats a blockage in the small tear-drainage channels near the eyelid.

CMS RVU26DEffective Oct 1, 2026One payment locality30K Medicare services in 2024

In Nevada, Medicare pays $133.86 for 68840 in the office and $104.10 when it’s performed in a hospital or facility.

$133.86Office (non-facility)
$104.10Hospital or facility
−0.3%vs the national office rate ($134.27)

Check a contract rate as a % of Medicare · 68840 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 68840 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 68840 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 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.

How Nevada compares for 68840

Across 109 of 109 payment localities, the office rate for 68840 runs from $120.29 in Arkansas to $176.81 in San Benito County, CA. Nevada pays $133.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

68840 in Nevada vs other payment areas
  1. Nevada · this page$133.86
  2. Los Angeles, CA · California$151.26+$17.40
  3. Washington, DC area · District of Columbia$152.72+$18.86
  4. Miami, FL · Florida$142.51+$8.65
  5. Chicago, IL · Illinois$138.91+$5.05
  6. Manhattan, NY · New York$153.14+$19.28
  7. Alaska · Alaska$159.91+$26.05

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

Every other payment area

68840 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$121.86$95.85
ArkansasArkansas$120.29$94.75
ArizonaArizona$131.08$102.28
Bakersfield, CACalifornia$142.43$109.85
Chico, CACalifornia$142.13$109.55
El Centro, CACalifornia$142.14$109.56
Fresno, CACalifornia$142.13$109.55
Hanford, CACalifornia$142.13$109.55

68840 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.

$120.29

$159.91

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

View every state and territory as a table
68840 office rate range by state
State / territoryOffice rate rangeLocalities
AK$159.911
AL$121.861
AR$120.291
AZ$131.081
CA$142.13–$176.8129
CO$139.811
CT$142.591
DC$152.721
DE$133.111
FL$131.87–$142.513
GA$125.25–$136.422
GU$145.181
HI$145.181
IA$124.911
ID$125.581
IL$128.23–$139.294
IN$126.241
KS$124.251
KY$124.151
LA$123.93–$129.442
MA$139.05–$152.922
MD$135.52–$152.723
ME$126.03–$132.362
MI$126.93–$133.222
MN$134.731
MO$121.93–$130.013
MS$121.141
MT$134.271
NC$127.231
ND$132.491
NE$125.561
NH$137.541
NJ$144.43–$151.362
NM$127.501
NV$133.861
NY$128.94–$156.355
OH$126.571
OK$124.091
OR$133.02–$144.042
PA$126.82–$139.262
PR$135.201
RI$137.681
SC$127.071
SD$132.281
TN$124.791
TX$126.06–$139.178
UT$128.631
VA$131.88–$152.722
VI$135.201
VT$131.901
WA$138.81–$156.012
WI$128.461
WV$123.931
WY$133.491

See 68840 in every payment locality

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

Office or facility?

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.

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,576

Code
68840
Physician work
1.27
Practice expense
2.66
Malpractice
0.09

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 68840 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.27× 1.0001.2700
Practice expense2.66× 1.0012.6627
Malpractice0.09× 0.8330.0750
Total RVUs4.0076
Conversion factor× 33.4009

Office rate, Nevada$133.86

Office: (1.27 × 1 + 2.66 × 1.001 + 0.09 × 0.833) × $33.4009 = $133.86

Facility: (1.27 × 1 + 1.77 × 1.001 + 0.09 × 0.833) × $33.4009 = $104.10

Open 68840 in the RVU calculator

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

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)1Not paid (statutory restriction).
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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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).

When to use modifier 50

How 68840 has changed in Nevada

68840 · Office / nonfacility

$133.86

Effective 2026-10-01

The base rate is $5.95 higher than on 2025-10-01, moving from $127.91 to $133.86 (4.7%).

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

    $127.91changed to$133.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.30 changed to 1.27
    • Practice expense RVU 2.57 changed to 2.66
    • Malpractice RVU 0.10 changed to 0.09
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $132.30changed to$127.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.59 changed to 2.57

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $130.14changed to$132.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $134.53changed to$130.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.56 changed to 2.59
    • Malpractice GPCI 1.098 changed to 0.844
  5. January 1, 2023

    RVU23A

    $136.40changed to$134.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.50 changed to 2.56
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $136.49changed to$136.40

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.47 changed to 2.50

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $134.14changed to$136.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.31 changed to 2.47
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $133.46changed to$134.14

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.28 changed to 2.31
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $132.95changed to$133.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.27 changed to 2.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $132.28changed to$132.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.22 changed to 2.27
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $133.48changed to$132.28

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $133.96changed to$133.48

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $133.30changed to$133.96

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $139.64changed to$133.30

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.23 changed to 0.09
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $142.12changed to$139.64

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.44 changed to 2.22
    • Malpractice RVU 0.24 changed to 0.23
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$142.12

  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$133.86$104.10RVU26D
2026-07-01$133.86$104.10RVU26C
2026-04-01$133.86$104.10RVU26B
2026-01-01$133.86$104.10RVU26A
2025-10-01$127.91$113.03RVU25D
2025-07-01$127.91$113.03RVU25C
2025-04-01$127.91$113.03RVU25B
2025-01-01$127.91$113.03RVU25A
2024-10-01$132.30$115.99RVU24D
2024-07-01$132.30$115.99RVU24C
2024-04-01$132.30$115.99RVU24B
2024-03-09$132.30$115.99RVU24AR
2024-01-01$130.14$114.09RVU24A
2023-10-01$134.53$117.58RVU23D
2023-07-01$134.53$117.58RVU23C
2023-04-01$134.53$117.58RVU23B
2023-01-01$134.53$117.58RVU23A
2022-10-01$136.40$118.41RVU22D
2022-07-01$136.40$118.41RVU22C
2022-04-01$136.40$118.41RVU22B
2022-01-01$136.40$118.41RVU22A
2021-10-01$136.49$119.04RVU21D
2021-07-01$136.49$119.04RVU21C
2021-04-01$136.49$119.04RVU21B
2021-01-01$136.49$119.04RVU21A
2020-10-01$134.14$118.62RVU20D
2020-07-01$134.14$118.62RVU20C
2020-04-01$134.14$118.62RVU20B
2020-01-01$134.14$118.62RVU20A
2019-10-01$133.46$120.26RVU19D
2019-07-01$133.46$120.26RVU19C
2019-04-01$133.46$120.26RVU19B
2019-01-01$133.46$120.26RVU19A
2018-10-01$132.95$120.50RVU18D
2018-07-01$132.95$120.50RVU18C
2018-04-01$132.95$120.50RVU18B
2018-01-01$132.95$120.50RVU18AR1
2017-10-01$132.28$120.78RVU17D
2017-07-01$132.28$120.78RVU17C
2017-04-01$132.28$120.78RVU17B
2017-01-01$132.28$120.78RVU17A
2016-10-01$133.48$122.19RVU16D
2016-07-01$133.48$122.19RVU16C
2016-04-01$133.48$122.19RVU16B
2016-01-01$133.48$122.19RVU16A
2015-10-01$133.96$122.63RVU15D
2015-07-01$133.96$122.63RVU15C
2015-04-01$133.30$122.02RVU15B
2015-01-01$133.30$122.02RVU15A
2014-10-01$139.64$128.30RVU14D
2014-07-01$139.64$128.30RVU14C
2014-04-01$139.64$128.30RVU14B
2014-01-01$139.64$128.30RVU14A
2013-10-01$142.12$129.88RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 68840 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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
RVUs for 68840PPRRVU2026_Oct_nonQPP.csv, line 7,576 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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