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CPT code 68840: Tear duct probing, lacrimal canaliculi2026 Medicare rate & RVUs in King County, WA

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 King County, WA, Medicare pays $156.01 for 68840 in the office and $119.54 when it’s performed in a hospital or facility.

$156.01Office (non-facility)
$119.54Hospital or facility
+16.2%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 King County, WA
  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 King County, WA 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. King County, WA pays $156.01. The RVUs are the same everywhere; the geographic indexes change the dollars.

68840 in King County, WA vs other payment areas
  1. King County, WA · this page$156.01
  2. Rest of Washington · Washington$138.81−$17.20
  3. Los Angeles, CA · California$151.26−$4.75
  4. Washington, DC area · District of Columbia$152.72−$3.29
  5. Miami, FL · Florida$142.51−$13.50
  6. Chicago, IL · Illinois$138.91−$17.10
  7. Manhattan, NY · New York$153.14−$2.87

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

Every other payment area

68840 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$159.91$128.25
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

68840 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.

$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 King County, WA 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

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 68840 in King County, WA
ComponentRVULocality factorAdjusted
Physician work1.27× 1.0501.3335
Practice expense2.66× 1.2273.2638
Malpractice0.09× 0.8170.0735
Total RVUs4.6709
Conversion factor× 33.4009

Office rate, King County, WA$156.01

Office: (1.27 × 1.05 + 2.66 × 1.227 + 0.09 × 0.817) × $33.4009 = $156.01

Facility: (1.27 × 1.05 + 1.77 × 1.227 + 0.09 × 0.817) × $33.4009 = $119.54

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

Codes related to 68840

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

Codes related to 68840
CodeHow it relatesOffice range, King County, WA
Used instead
68801Punctum dilation, punctal opening, with or without irrigationDilation of a stenotic lacrimal punctum is a different intervention at the tear-drainage opening.$110.57
68810Tear duct probing, simple probingProbes the nasolacrimal duct rather than the lacrimal canaliculi.$186.62
68811Tear duct probing, general anesthesiaNasolacrimal duct probing when general anesthesia is required.No office rate
68815Duct probing, with tube or stentNasolacrimal duct probing with insertion of a tube or stent.$439.35
68816Tear duct dilation, balloon catheterNasolacrimal duct probing with balloon catheter dilation.$1,006.16

How 68840 has changed in King County, WA

68840 · Office / nonfacility

$156.01

Effective 2026-10-01

The base rate is $7.97 higher than on 2025-10-01, moving from $148.04 to $156.01 (5.4%).

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

    $148.04changed to$156.01

    • 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
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $153.16changed to$148.04

    • 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

    $150.66changed to$153.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $153.24changed to$150.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.56 changed to 2.59
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $152.59changed to$153.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.50 changed to 2.56
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $152.61changed to$152.59

    • 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

    $148.68changed to$152.61

    • 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 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $145.30changed to$148.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.28 changed to 2.31
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $144.73changed to$145.30

    • 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

    $141.87changed to$144.73

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.22 changed to 2.27
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $141.11changed to$141.87

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $141.62changed to$141.11

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $140.91changed to$141.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $144.86changed to$140.91

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.23 changed to 0.09
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $147.50changed to$144.86

    • 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
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $147.50

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$156.01$119.54RVU26D
2026-07-01$156.01$119.54RVU26C
2026-04-01$156.01$119.54RVU26B
2026-01-01$156.01$119.54RVU26A
2025-10-01$148.04$129.88RVU25D
2025-07-01$148.04$129.88RVU25C
2025-04-01$148.04$129.88RVU25B
2025-01-01$148.04$129.88RVU25A
2024-10-01$153.16$133.26RVU24D
2024-07-01$153.16$133.26RVU24C
2024-04-01$153.16$133.26RVU24B
2024-03-09$153.16$133.26RVU24AR
2024-01-01$150.66$131.08RVU24A
2023-10-01$153.24$132.79RVU23D
2023-07-01$153.24$132.79RVU23C
2023-04-01$153.24$132.79RVU23B
2023-01-01$153.24$132.79RVU23A
2022-10-01$152.59$131.11RVU22D
2022-07-01$152.59$131.11RVU22C
2022-04-01$152.59$131.11RVU22B
2022-01-01$152.59$131.11RVU22A
2021-10-01$152.61$131.78RVU21D
2021-07-01$152.61$131.78RVU21C
2021-04-01$152.61$131.78RVU21B
2021-01-01$152.61$131.78RVU21A
2020-10-01$148.68$130.53RVU20D
2020-07-01$148.68$130.53RVU20C
2020-04-01$148.68$130.53RVU20B
2020-01-01$148.68$130.53RVU20A
2019-10-01$145.30$130.43RVU19D
2019-07-01$145.30$130.43RVU19C
2019-04-01$145.30$130.43RVU19B
2019-01-01$145.30$130.43RVU19A
2018-10-01$144.73$130.70RVU18D
2018-07-01$144.73$130.70RVU18C
2018-04-01$144.73$130.70RVU18B
2018-01-01$144.73$130.70RVU18AR1
2017-10-01$141.87$129.07RVU17D
2017-07-01$141.87$129.07RVU17C
2017-04-01$141.87$129.07RVU17B
2017-01-01$141.87$129.07RVU17A
2016-10-01$141.11$128.70RVU16D
2016-07-01$141.11$128.70RVU16C
2016-04-01$141.11$128.70RVU16B
2016-01-01$141.11$128.70RVU16A
2015-10-01$141.62$129.17RVU15D
2015-07-01$141.62$129.17RVU15C
2015-04-01$140.91$128.53RVU15B
2015-01-01$140.91$128.53RVU15A
2014-10-01$144.86$132.50RVU14D
2014-07-01$144.86$132.50RVU14C
2014-04-01$144.86$132.50RVU14B
2014-01-01$144.86$132.50RVU14A
2013-10-01$147.50$134.27RVU13D
2013-07-01$147.50$134.27RVU13C
2013-04-01$147.50$134.27RVU13B
2013-01-01$147.50$134.27RVU13AR

Price 68840 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 68840 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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 King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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