Billing code 68705: Punctum revisionMedicare rate & RVUs
Reconstructs a narrowed or abnormal lacrimal punctum to improve tear drainage, with dilation included when performed as part of the repair.
Medicare pays $259.86 for 68705 nationally in the office and $143.29 in a hospital or facility. Local office rates run $230.97–$346.73.
Medicare rate · 68705
Punctum revision
Swap in your local Medicare rate.
- Work RVUs
- 2.06
- Total RVUs
- 7.78
- Global days
- 010
National rate · 2026
$259.86
Office setting, before claim adjustments.
See every locality for 68705 → · 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
What 68705 covers
This procedure revises and reconstructs the lacrimal punctum, the small opening at the inner eyelid that drains tears. Ophthalmologists, including oculoplastic surgeons, may perform it for a narrowed or abnormal punctum associated with impaired tear drainage, such as persistent tearing. It may be performed in an office or an operating room, depending on the clinical circumstances and the extent of repair.
Report the code when the service involves reconstruction of the punctum; dilation performed as part of that service is included. Documentation should identify the affected side, the punctal abnormality, and the reconstruction performed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. For bilateral services, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 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.
Where 68705 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$230.97 to $346.73
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $234.22 | $132.22 |
| Alaska* | $303.76 | $179.62 |
| Arizona | $253.29 | $140.34 |
| Arkansas | $230.97 | $130.83 |
| Atlanta | $264.17 | $145.74 |
| Austin | $270.10 | $146.77 |
| Bakersfield | $276.74 | $148.98 |
| Baltimore/Surr. Cntys | $275.84 | $150.76 |
| Beaumont | $242.77 | $136.69 |
| Brazoria | $257.49 | $141.97 |
| Chicago | $268.62 | $151.47 |
| Chico | $276.19 | $148.43 |
| Colorado | $271.31 | $147.28 |
| Connecticut | $276.70 | $151.16 |
| Dallas | $258.93 | $142.83 |
| Dc + Md/Va Suburbs | $297.21 | $159.89 |
| Delaware | $257.41 | $142.23 |
| Detroit | $257.27 | $144.78 |
| East St. Louis | $250.79 | $143.54 |
| El Centro | $276.22 | $148.46 |
| Fort Lauderdale | $266.86 | $148.77 |
| Fort Worth | $257.15 | $142.21 |
| Fresno | $276.19 | $148.43 |
| Galveston | $258.14 | $142.38 |
| Hanford-Corcoran | $276.19 | $148.43 |
| Hawaii, Guam | $282.86 | $150.33 |
| Houston | $261.25 | $145.49 |
| Idaho | $242.04 | $134.79 |
| Indiana | $243.41 | $135.35 |
| Iowa | $240.68 | $134.02 |
| Kansas | $239.25 | $133.87 |
| Kentucky | $238.80 | $135.17 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $294.70 | $156.79 |
| Madera | $276.19 | $148.43 |
| Manhattan | $297.62 | $162.17 |
| Merced | $276.19 | $148.43 |
| Metropolitan Boston | $298.02 | $158.83 |
| Metropolitan Kansas City | $248.42 | $138.96 |
| Metropolitan Philadelphia | $269.79 | $148.45 |
| Metropolitan St. Louis | $250.97 | $140.00 |
| Miami | $276.14 | $154.79 |
| Minnesota | $261.24 | $141.29 |
| Mississippi | $232.61 | $132.24 |
| Modesto | $276.19 | $148.43 |
| Montana** | $259.85 | $143.28 |
| Napa | $320.35 | $166.71 |
| Nebraska | $242.05 | $134.46 |
| Nevada** | $259.10 | $142.41 |
| New Hampshire | $266.75 | $145.40 |
| New Mexico | $245.61 | $138.72 |
| New Orleans | $249.69 | $140.00 |
| North Carolina | $245.39 | $136.63 |
| North Dakota** | $256.49 | $139.92 |
| Northern Nj | $294.24 | $159.02 |
| Nyc Suburbs/Long Island | $304.16 | $165.56 |
| Ohio | $243.78 | $137.35 |
| Oklahoma | $238.76 | $134.66 |
| Oxnard-Thousand Oaks-Ventura | $293.38 | $155.60 |
| Portland | $280.08 | $150.57 |
| Poughkpsie/N Nyc Suburbs | $281.76 | $154.12 |
| Puerto Rico | $261.81 | $143.96 |
| Queens | $300.51 | $162.73 |
| Redding | $276.19 | $148.43 |
| Rest Of California | $276.19 | $148.43 |
| Rest Of Florida | $254.56 | $143.12 |
| Rest Of Georgia | $240.93 | $136.95 |
| Rest Of Illinois | $246.93 | $140.50 |
| Rest Of Louisiana | $238.30 | $135.14 |
| Rest Of Maine | $242.88 | $135.64 |
| Rest Of Maryland | $262.31 | $144.34 |
| Rest Of Massachusetts | $269.63 | $146.88 |
| Rest Of Michigan | $244.46 | $138.04 |
| Rest Of Missouri | $234.13 | $133.65 |
| Rest Of New Jersey | $280.22 | $152.92 |
| Rest Of New York | $248.90 | $138.16 |
| Rest Of Oregon | $257.43 | $141.33 |
| Rest Of Pennsylvania | $244.35 | $137.34 |
| Rest Of Texas | $249.85 | $139.23 |
| Rest Of Washington | $269.22 | $146.47 |
| Rhode Island | $266.67 | $146.25 |
| Riverside-San Bernardino-Ontario | $278.06 | $150.30 |
| Sacramento-Roseville-Folsom | $289.92 | $154.35 |
| Salinas | $288.83 | $153.73 |
| San Diego-Chula Vista-Carlsbad | $295.66 | $156.24 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $339.33 | $174.96 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $339.13 | $174.77 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $346.73 | $178.64 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $345.94 | $177.85 |
| San Luis Obispo-Paso Robles | $284.16 | $151.39 |
| Santa Cruz-Watsonville | $298.52 | $156.89 |
| Santa Maria-Santa Barbara | $289.92 | $154.00 |
| Santa Rosa-Petaluma | $301.55 | $158.41 |
| Seattle (King Cnty) | $304.34 | $161.31 |
| South Carolina | $244.92 | $137.21 |
| South Dakota** | $256.09 | $139.52 |
| Southern Maine | $256.10 | $140.58 |
| Stockton | $276.19 | $148.43 |
| Suburban Chicago | $269.73 | $150.01 |
| Tennessee | $240.36 | $134.40 |
| Utah | $248.16 | $138.58 |
| Vallejo | $320.07 | $166.43 |
| Vermont | $255.20 | $139.80 |
| Virgin Islands | $261.81 | $143.96 |
| Virginia | $255.04 | $140.45 |
| Visalia | $276.19 | $148.43 |
| West Virginia | $238.02 | $136.72 |
| Wisconsin | $248.14 | $136.47 |
| Wyoming** | $258.38 | $141.81 |
| Yuba City | $276.19 | $148.43 |
68705 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.
$230.97
$311.46
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 | $303.76 | 1 |
| AL | $234.22 | 1 |
| AR | $230.97 | 1 |
| AZ | $253.29 | 1 |
| CA | $276.19–$346.73 | 29 |
| CO | $271.31 | 1 |
| CT | $276.70 | 1 |
| DC | $297.21 | 1 |
| DE | $257.41 | 1 |
| FL | $254.56–$276.14 | 3 |
| GA | $240.93–$264.17 | 2 |
| GU | $282.86 | 1 |
| HI | $282.86 | 1 |
| IA | $240.68 | 1 |
| ID | $242.04 | 1 |
| IL | $246.93–$269.73 | 4 |
| IN | $243.41 | 1 |
| KS | $239.25 | 1 |
| KY | $238.80 | 1 |
| LA | $238.30–$249.69 | 2 |
| MA | $269.63–$298.02 | 2 |
| MD | $262.31–$297.21 | 3 |
| ME | $242.88–$256.10 | 2 |
| MI | $244.46–$257.27 | 2 |
| MN | $261.24 | 1 |
| MO | $234.13–$250.97 | 3 |
| MS | $232.61 | 1 |
| MT | $259.85 | 1 |
| NC | $245.39 | 1 |
| ND | $256.49 | 1 |
| NE | $242.05 | 1 |
| NH | $266.75 | 1 |
| NJ | $280.22–$294.24 | 2 |
| NM | $245.61 | 1 |
| NV | $259.10 | 1 |
| NY | $248.90–$304.16 | 5 |
| OH | $243.78 | 1 |
| OK | $238.76 | 1 |
| OR | $257.43–$280.08 | 2 |
| PA | $244.35–$269.79 | 2 |
| PR | $261.81 | 1 |
| RI | $266.67 | 1 |
| SC | $244.92 | 1 |
| SD | $256.09 | 1 |
| TN | $240.36 | 1 |
| TX | $242.77–$270.10 | 8 |
| UT | $248.16 | 1 |
| VA | $255.04–$297.21 | 2 |
| VI | $261.81 | 1 |
| VT | $255.20 | 1 |
| WA | $269.22–$304.34 | 2 |
| WI | $248.14 | 1 |
| WV | $238.02 | 1 |
| WY | $258.38 | 1 |
How the 68705 rate is calculated
Each of 68705’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 · 68705
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.06Practice expense 5.55Malpractice 0.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 68705
68705 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68705
Punctum revision
| 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 · 68705
Punctum revision
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
68705 without 50 · national office
$259.86
Punctum revision
68705-50 · Bilateral: 150%
$389.79
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).
68705 compared with similar codes
Compare codes
68705 vs 68801 vs 68700 vs 68760 vs 68761: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 68801Punctum dilation
- Use 68801 for punctal dilation without reconstruction. Use 68705 when the service reconstructs the punctum, whether or not dilation is also performed.
- 68700Canaliculus repair
- 68700 addresses repair of the lacrimal canaliculus; 68705 addresses reconstruction of the punctal opening.
- 68760Punctal closure
- 68760 closes the punctum to reduce tear drainage. 68705 reconstructs the opening, commonly to address impaired drainage.
- 68761Punctal occlusion
- 68761 closes the punctum with a plug. 68705 reconstructs the punctal opening rather than occluding it.
68705 billing questions
When should 68705 be chosen instead of punctal dilation?
Use 68705 when the punctum is reconstructed, with or without dilation. Simple dilation without reconstruction is reported with 68801.
Can dilation be billed separately with 68705?
Dilation performed as part of the punctal reconstruction is included in 68705. The code covers reconstruction whether or not dilation is performed.
How is a bilateral punctal reconstruction reported?
For bilateral services, report modifier 50. CMS pays the bilateral procedure at 150%.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay for 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
Show the CMS file lines behind this rate
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