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Billing code 68720: Tear drainage surgeryMedicare rate & RVUs

Surgical creation of a drainage passage from the lacrimal sac into the nose treats tear outflow obstruction without tube or stent intubation.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.7K Medicare services in 2024

Medicare pays $702.75 for 68720 nationally in a facility.

Medicare rate · 68720

Tear drainage surgery

Swap in your local Medicare rate.

Work RVUs
9.71
Total RVUs
21.04
Global days
090

National rate · 2026

$702.75

Facility setting, before claim adjustments.

See every locality for 68720 → · 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 68720 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 68720 covers

An ophthalmic surgeon creates a direct passage from the lacrimal sac into the nasal cavity to bypass an obstructed nasolacrimal duct. The operation is used for tear drainage problems such as persistent tearing or recurrent infection of the lacrimal sac. It is generally performed in an operating-room setting, including a hospital outpatient department or ambulatory surgery center. This code describes the DCR without tube or stent intubation.

The operative report should support the lacrimal sac-to-nose bypass, identify the treated side, and clarify whether a tube or stent was inserted. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 68720 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

68720 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$646.99
Alaska*Unavailable$875.44
ArizonaUnavailable$687.93
ArkansasUnavailable$639.97
AtlantaUnavailable$714.85
AustinUnavailable$720.64
BakersfieldUnavailable$731.91
Baltimore/Surr. CntysUnavailable$740.06
BeaumontUnavailable$669.22
BrazoriaUnavailable$696.16

68720 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
68720 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 68720 rate is calculated

Each of 68720’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 · 68720

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.71Practice expense 10.51Malpractice 0.82

21.0400 adjusted RVUs×$33.4009 conversion factor=$702.75

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

Payment rules and modifiers for 68720

68720 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68720

Tear drainage 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 68720

Tear drainage 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

68720 without 50 · national facility

$702.75

Tear drainage surgery

68720-50 · Bilateral: 150%

$1,054.13

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

68720 compared with similar codes

Compare codes

68720 vs 68745 vs 68750 vs 68705: national Medicare rates

Swap in your local Medicare rate.

  • 68720
    Tear drainage surgery · 9.71 wRVU
    —
  • 68745
    Tear duct bypass · 9.65 wRVU
    —
  • 68750
    Tear drainage bypass · 9.85 wRVU
    —
  • 68705
    Punctum revision · 2.06 wRVU
    $259.86

How to choose

68745Tear duct bypass
Both describe DCR, but 68745 includes tube or stent insertion; 68720 is the no-intubation service.
68750Tear drainage bypass
68750 creates a conjunctivorhinostomy bypass, while 68720 creates a drainage passage from the lacrimal sac into the nose.
68705Punctum revision
68705 is probing of the nasolacrimal duct, with or without irrigation. Choose 68720 when the surgeon creates a surgical bypass from the lacrimal sac to the nose.

Codes related to 68720

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

Codes related to 68720
CodeHow it relatesNational office range
Same family
68745Tear duct bypassDCR with tube or stent intubation, unlike this code's no-intubation service.No office rate
Used instead
68750Tear drainage bypassCreates a different tear-drainage bypass for situations requiring a conjunctivorhinostomy.No office rate
68705Punctum revisionProbes the nasolacrimal duct rather than surgically creating a sac-to-nose passage.$230.97–$346.73

68720 billing questions

How is this code distinguished from a DCR with intubation?

Report 68720 when the DCR is performed without a tube or stent. A DCR that includes tube or stent insertion is represented by 68745.

Can the tube or stent be billed separately with 68720?

This code represents a DCR without intubation. If a tube or stent is inserted as part of the DCR, use the applicable DCR code for that service rather than treating the implant as a separate 68720 service.

What documentation supports reporting 68720?

The operative report should describe creation of the lacrimal sac-to-nasal passage, the clinical obstruction being bypassed, the side treated, and whether intubation was performed.

How is bilateral DCR reported?

For bilateral procedures, report modifier 50; CMS payment for the bilateral procedure is 150%.

Are related postoperative visits included?

Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeons are paid only when supporting documentation is provided.

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 68720PPRRVU2026_Oct_nonQPP.csv, line 7,565 (RVU26D)

Open CMS sourceHow we calculate rates

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