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Billing code 68500: Lacrimal gland surgeryMedicare rate & RVUs

Report complete surgical removal of a lacrimal gland when the operation removes the gland rather than taking a sample or removing only part.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $921.20 for 68500 nationally in a facility.

Medicare rate · 68500

Lacrimal gland surgery

Swap in your local Medicare rate.

Work RVUs
12.45
Total RVUs
27.58
Global days
090

National rate · 2026

$921.20

Facility setting, before claim adjustments.

See every locality for 68500 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 68500 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 68500 covers

This code represents complete surgical removal of a lacrimal gland, the tear-producing gland located in the upper outer portion of the orbit. An ophthalmologist, commonly an oculoplastic surgeon, performs the operation when the gland itself must be removed; it is distinct from taking a diagnostic sample or excising only part of the gland. The operative report should identify the gland and side, explain the clinical reason for removal, and describe the extent of excision.

Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery reported with modifier 50, payment is at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted. Documentation should make clear that the gland was completely removed, rather than partially excised or biopsied.

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.

Where 68500 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

68500 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$847.60
Alaska*Unavailable$1,144.63
ArizonaUnavailable$901.72
ArkansasUnavailable$838.34
AtlantaUnavailable$936.77
AustinUnavailable$945.54
BakersfieldUnavailable$961.18
Baltimore/Surr. CntysUnavailable$970.27
BeaumontUnavailable$876.36
BrazoriaUnavailable$912.86

68500 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
68500 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 68500 rate is calculated

Each of 68500’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 · 68500

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.45Practice expense 14.12Malpractice 1.01

27.5800 adjusted RVUs×$33.4009 conversion factor=$921.20

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 68500

68500 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68500

Lacrimal gland surgery

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68500

Lacrimal gland surgery

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68500 without 50 · national facility

$921.20

Lacrimal gland surgery

68500-50 · Bilateral: 150%

$1,381.80

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

68500 compared with similar codes

Compare codes

68500 vs 68505 vs 68510 vs 68520: national Medicare rates

Swap in your local Medicare rate.

  • 68500
    Lacrimal gland surgery · 12.45 wRVU
    —
  • 68505
    Lacrimal gland surgery · 12.37 wRVU
    —
  • 68510
    Lacrimal biopsy · 4.49 wRVU
    $450.91
  • 68520
    Tear sac surgery · 8.56 wRVU
    —

How to choose

68505Lacrimal gland surgery
Choose 68500 for complete gland removal and 68505 when only part of the gland is excised.
68510Lacrimal biopsy
68510 represents a diagnostic biopsy. It is not the code for removal of the entire gland.
68520Tear sac surgery
68520 concerns removal of the lacrimal sac; 68500 concerns the tear-producing lacrimal gland.

Codes related to 68500

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

Codes related to 68500
CodeHow it relatesNational office range
Same family
68505Lacrimal gland surgeryPartial gland removal; distinguish it from complete removal reported with 68500.No office rate
Used instead
68510Lacrimal biopsyBiopsy is appropriate when tissue sampling, rather than gland removal, is performed.$404.34–$589.53
68520Tear sac surgeryThis removes the lacrimal sac, a different structure from the lacrimal gland.No office rate

68500 billing questions

When should 68500 be chosen instead of 68505?

Use 68500 when the operation removes the entire lacrimal gland. Use 68505 for partial gland removal, and document the extent excised.

Can a diagnostic gland sample be reported as 68500?

No. A procedure limited to obtaining tissue for diagnosis is a biopsy, represented by 68510; 68500 describes complete gland removal.

How is bilateral gland removal reported?

Report bilateral surgery with modifier 50. CMS pays this bilateral procedure at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon or co-surgeon be paid?

Medicare does not pay an assistant at surgery for 68500. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

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 68500PPRRVU2026_Oct_nonQPP.csv, line 7,555 (RVU26D)

Open CMS sourceHow we calculate rates

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