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CMS RVU26D · Effective 2026-10-01

68801 in Merced

Office / nonfacility

$100.55

Base rate per service

Facility setting

$75.66

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Ophthalmology procedure

About 68801: Lacrimal punctum dilation

Reports dilation of a narrowed lacrimal punctum, with or without irrigation, to improve tear drainage through the opening.

An ophthalmologist or other qualified eye-care practitioner dilates a narrowed lacrimal punctum, the small opening at the eyelid margin that drains tears. The service may include irrigation through the opened punctum. It is typically performed in an office or outpatient setting when punctal narrowing interferes with tear drainage; it addresses the punctal opening rather than probing the downstream canaliculus or nasolacrimal duct.

Report 68801 when the documented service is dilation of the punctum, and record the affected side, the narrowing treated, and whether irrigation was performed. Irrigation is included in this 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 the others at 50%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 68801

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU0.80 · 28%
  • Practice expense (office) RVU1.98 · 70%
  • Malpractice RVU0.05 · 2%

16K

Medicare services in 2024 · #1235 by national volume

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.

68801 compared with similar codes

Office rates for Merced, from the same CMS release.

68810

Tear duct probing

Simple probing

$169.88

Choose 68801 for dilation of a stenotic punctum. Choose 68810 when the documented service probes the nasolacrimal duct.

68840

Tear duct probing

Lacrimal canaliculi

$142.13

68840 involves probing the lacrimal canaliculi. 68801 is specific to dilation of the punctal opening.

68816

Tear duct dilation

Balloon catheter

$903.12

68816 describes balloon catheter dilation of the nasolacrimal duct with probing. 68801 treats narrowing at the punctum.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 68801 is $100.73—$0.18 higher than the $100.55 rate in Merced. Both use the same code, release and participation basis.

68801 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $100.55

  2. Bakersfield

    $100.73

    $0.18 higher than Merced

  3. Chico

    $100.55

    The same base rate than Merced

  4. El Centro

    $100.56

    $0.01 higher than Merced

  5. Fresno

    $100.55

    The same base rate than Merced

  6. Hanford-Corcoran

    $100.55

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $107.16

    $6.61 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 68801 ranges from $84.39 in Arkansas to $125.92 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Modesto

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Napa

    California · 68801

    Office

    $116.42

    Facility

    $86.48

    $15.87 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 68801

    Office

    $106.68

    Facility

    $79.83

    $6.13 higher than Merced for the office setting.

  • Redding

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 68801

    Office

    $101.11

    Facility

    $76.22

    $0.56 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 68801

    Office

    $105.49

    Facility

    $79.08

    $4.94 higher than Merced for the office setting.

  • Salinas

    California · 68801

    Office

    $105.09

    Facility

    $78.77

    $4.54 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 68801

    Office

    $107.52

    Facility

    $80.36

    $6.97 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 68801

    Office

    $123.27

    Facility

    $91.25

    $22.72 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 68801

    Office

    $123.22

    Facility

    $91.19

    $22.67 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 68801

    Office

    $125.92

    Facility

    $93.17

    $25.37 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 68801

    Office

    $125.69

    Facility

    $92.94

    $25.14 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 68801

    Office

    $103.40

    Facility

    $77.53

    $2.85 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 68801

    Office

    $108.53

    Facility

    $80.93

    $7.98 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 68801

    Office

    $105.48

    Facility

    $78.99

    $4.93 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 68801

    Office

    $109.63

    Facility

    $81.74

    $9.08 higher than Merced for the office setting.

  • Stockton

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 68801

    Office

    $116.34

    Facility

    $86.40

    $15.79 higher than Merced for the office setting.

  • Visalia

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 68801

    Office

    $100.55

    Facility

    $75.66

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 68801

    Office

    $107.93

    Facility

    $81.17

    $7.38 higher than Merced for the office setting.

  • Miami

    Florida · 68801

    Office

    $99.79

    Facility

    $76.15

    $0.76 lower than Merced for the office setting.

  • Chicago

    Illinois · 68801

    Office

    $97.20

    Facility

    $74.38

    $3.35 lower than Merced for the office setting.

  • Manhattan

    New York · 68801

    Office

    $107.93

    Facility

    $81.53

    $7.38 higher than Merced for the office setting.

  • Alaska*

    Alaska · 68801

    Office

    $111.43

    Facility

    $87.24

    $10.88 higher than Merced for the office setting.

  • Alabama

    Alabama · 68801

    Office

    $85.53

    Facility

    $65.66

    $15.02 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 68801

    Office

    $84.39

    Facility

    $64.88

    $16.16 lower than Merced for the office setting.

  • Arizona

    Arizona · 68801

    Office

    $92.23

    Facility

    $70.23

    $8.32 lower than Merced for the office setting.

  • Colorado

    Colorado · 68801

    Office

    $98.71

    Facility

    $74.55

    $1.84 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 68801

    Office

    $100.50

    Facility

    $76.04

    $0.05 lower than Merced for the office setting.

  • Delaware

    Delaware · 68801

    Office

    $93.70

    Facility

    $71.26

    $6.85 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 68801

    Office

    $96.73

    Facility

    $73.73

    $3.82 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 68801

    Office

    $92.45

    Facility

    $70.74

    $8.10 lower than Merced for the office setting.

  • Atlanta

    Georgia · 68801

    Office

    $96.00

    Facility

    $72.92

    $4.55 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 68801

    Office

    $87.70

    Facility

    $67.44

    $12.85 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 68801

    Office

    $102.88

    Facility

    $77.06

    $2.33 higher than Merced for the office setting.

  • Iowa

    Iowa · 68801

    Office

    $87.90

    Facility

    $67.11

    $12.65 lower than Merced for the office setting.

  • Idaho

    Idaho · 68801

    Office

    $88.35

    Facility

    $67.46

    $12.20 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 68801

    Office

    $90.93

    Facility

    $70.03

    $9.62 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 68801

    Office

    $89.71

    Facility

    $68.97

    $10.84 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 68801

    Office

    $97.79

    Facility

    $74.46

    $2.76 lower than Merced for the office setting.

  • Indiana

    Indiana · 68801

    Office

    $88.84

    Facility

    $67.78

    $11.71 lower than Merced for the office setting.

  • Kansas

    Kansas · 68801

    Office

    $87.35

    Facility

    $66.82

    $13.20 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 68801

    Office

    $87.04

    Facility

    $66.85

    $13.51 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 68801

    Office

    $90.85

    Facility

    $69.48

    $9.70 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 68801

    Office

    $86.85

    Facility

    $66.75

    $13.70 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 68801

    Office

    $108.27

    Facility

    $81.15

    $7.72 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 68801

    Office

    $98.12

    Facility

    $74.20

    $2.43 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 68801

    Office

    $100.18

    Facility

    $75.81

    $0.37 lower than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 68801

    Office

    $95.45

    Facility

    $72.46

    $5.10 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 68801

    Office

    $88.60

    Facility

    $67.71

    $11.95 lower than Merced for the office setting.

  • Southern Maine

    Maine · 68801

    Office

    $93.31

    Facility

    $70.80

    $7.24 lower than Merced for the office setting.

  • Detroit

    Michigan · 68801

    Office

    $93.36

    Facility

    $71.44

    $7.19 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 68801

    Office

    $88.99

    Facility

    $68.25

    $11.56 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 68801

    Office

    $95.27

    Facility

    $71.90

    $5.28 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 68801

    Office

    $90.45

    Facility

    $69.12

    $10.10 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 68801

    Office

    $91.35

    Facility

    $69.73

    $9.20 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 68801

    Office

    $85.35

    Facility

    $65.78

    $15.20 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 68801

    Office

    $84.90

    Facility

    $65.34

    $15.65 lower than Merced for the office setting.

  • Montana**

    Montana · 68801

    Office

    $94.52

    Facility

    $71.81

    $6.03 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 68801

    Office

    $89.49

    Facility

    $68.30

    $11.06 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 68801

    Office

    $93.53

    Facility

    $70.82

    $7.02 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 68801

    Office

    $88.39

    Facility

    $67.43

    $12.16 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 68801

    Office

    $97.03

    Facility

    $73.38

    $3.52 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 68801

    Office

    $106.90

    Facility

    $80.56

    $6.35 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 68801

    Office

    $101.84

    Facility

    $77.04

    $1.29 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 68801

    Office

    $89.37

    Facility

    $68.54

    $11.18 lower than Merced for the office setting.

  • Nevada**

    Nevada · 68801

    Office

    $94.31

    Facility

    $71.58

    $6.24 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 68801

    Office

    $110.17

    Facility

    $83.16

    $9.62 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 68801

    Office

    $102.36

    Facility

    $77.49

    $1.81 higher than Merced for the office setting.

  • Queens

    New York · 68801

    Office

    $109.01

    Facility

    $82.16

    $8.46 higher than Merced for the office setting.

  • Rest Of New York

    New York · 68801

    Office

    $90.72

    Facility

    $69.14

    $9.83 lower than Merced for the office setting.

  • Ohio

    Ohio · 68801

    Office

    $88.78

    Facility

    $68.05

    $11.77 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 68801

    Office

    $87.08

    Facility

    $66.79

    $13.47 lower than Merced for the office setting.

  • Portland

    Oregon · 68801

    Office

    $101.87

    Facility

    $76.63

    $1.32 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 68801

    Office

    $93.76

    Facility

    $71.14

    $6.79 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 68801

    Office

    $98.04

    Facility

    $74.40

    $2.51 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 68801

    Office

    $89.01

    Facility

    $68.16

    $11.54 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 68801

    Office

    $95.23

    Facility

    $72.26

    $5.32 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 68801

    Office

    $97.03

    Facility

    $73.57

    $3.52 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 68801

    Office

    $89.25

    Facility

    $68.26

    $11.30 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 68801

    Office

    $93.42

    Facility

    $70.70

    $7.13 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 68801

    Office

    $87.73

    Facility

    $67.09

    $12.82 lower than Merced for the office setting.

  • Austin

    Texas · 68801

    Office

    $98.22

    Facility

    $74.19

    $2.33 lower than Merced for the office setting.

  • Beaumont

    Texas · 68801

    Office

    $88.45

    Facility

    $67.79

    $12.10 lower than Merced for the office setting.

  • Brazoria

    Texas · 68801

    Office

    $93.78

    Facility

    $71.27

    $6.77 lower than Merced for the office setting.

  • Dallas

    Texas · 68801

    Office

    $94.26

    Facility

    $71.64

    $6.29 lower than Merced for the office setting.

  • Fort Worth

    Texas · 68801

    Office

    $93.62

    Facility

    $71.23

    $6.93 lower than Merced for the office setting.

  • Galveston

    Texas · 68801

    Office

    $93.99

    Facility

    $71.43

    $6.56 lower than Merced for the office setting.

  • Houston

    Texas · 68801

    Office

    $94.90

    Facility

    $72.35

    $5.65 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 68801

    Office

    $90.99

    Facility

    $69.44

    $9.56 lower than Merced for the office setting.

  • Utah

    Utah · 68801

    Office

    $90.39

    Facility

    $69.04

    $10.16 lower than Merced for the office setting.

  • Virginia

    Virginia · 68801

    Office

    $92.91

    Facility

    $70.58

    $7.64 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 68801

    Office

    $95.23

    Facility

    $72.26

    $5.32 lower than Merced for the office setting.

  • Vermont

    Vermont · 68801

    Office

    $93.04

    Facility

    $70.55

    $7.51 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 68801

    Office

    $97.98

    Facility

    $74.06

    $2.57 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 68801

    Office

    $110.57

    Facility

    $82.70

    $10.02 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 68801

    Office

    $90.59

    Facility

    $68.83

    $9.96 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 68801

    Office

    $86.58

    Facility

    $66.84

    $13.97 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 68801

    Office

    $94.09

    Facility

    $71.38

    $6.46 lower than Merced for the office setting.

See how rates vary across the country

68801 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$84.39

$113.24

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$111.431
AL$85.531
AR$84.391
AZ$92.231
CA$100.55–$125.9229
CO$98.711
CT$100.501
DC$107.931
DE$93.701
FL$92.45–$99.793
GA$87.70–$96.002
GU$102.881
HI$102.881
IA$87.901
ID$88.351
IL$89.71–$97.794
IN$88.841
KS$87.351
KY$87.041
LA$86.85–$90.852
MA$98.12–$108.272
MD$95.45–$107.933
ME$88.60–$93.312
MI$88.99–$93.362
MN$95.271
MO$85.35–$91.353
MS$84.901
MT$94.521
NC$89.491
ND$93.531
NE$88.391
NH$97.031
NJ$101.84–$106.902
NM$89.371
NV$94.311
NY$90.72–$110.175
OH$88.781
OK$87.081
OR$93.76–$101.872
PA$89.01–$98.042
PR$95.231
RI$97.031
SC$89.251
SD$93.421
TN$87.731
TX$88.45–$98.228
UT$90.391
VA$92.91–$107.932
VI$95.231
VT$93.041
WA$97.98–$110.572
WI$90.591
WV$86.581
WY$94.091

Explore 68801 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 68801 in Merced, the physician’s office rate is $100.55 and the facility-setting rate is $75.66: a difference of $24.89.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 68801 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$110.61

$100.55 × 110% = $110.61

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 68801 in Merced.

PPRRVU2026_Oct_nonQPP.csv

7,571

Code
68801
Physician work
0.80
Practice expense
1.98
Malpractice
0.05

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 68801 in Merced
ComponentRVULocality factorAdjusted
Physician work0.80× 1.0170.8136
Practice expense1.98× 1.0962.1701
Malpractice0.05× 0.5360.0268
Total RVUs3.0105
Conversion factor× 33.4009

Office / nonfacility rate, Merced$100.55

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 68801 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.81.017
Practice expense1.981.096
Malpractice0.050.536

(0.8 × 1.017 + 1.98 × 1.096 + 0.05 × 0.536) × $33.4009 = $100.55

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.81.017
Practice expense1.31.096
Malpractice0.050.536

(0.8 × 1.017 + 1.3 × 1.096 + 0.05 × 0.536) × $33.4009 = $75.66

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

68801 · Office / nonfacility

$100.55

Effective 2026-10-01

The base rate is $2.93 higher than on 2025-10-01, moving from $97.62 to $100.55 (3.0%).

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

    $97.62changed to$100.55

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.82 changed to 0.80
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $97.62

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$100.55$75.66RVU26D
2026-07-01$100.55$75.66RVU26C
2026-04-01$100.55$75.66RVU26B
2026-01-01$100.55$75.66RVU26A
2025-10-01$97.62$81.01RVU25D
2025-07-01$97.62$81.01RVU25C
2025-04-01$97.62$81.01RVU25B
2025-01-01$97.62$81.01RVU25A

68801 billing questions

When should 68801 be chosen instead of 68810?

Use 68801 when the treated structure is a narrowed lacrimal punctum. Code 68810 describes probing the nasolacrimal duct, a different part of the tear drainage pathway.

Is irrigation separately reportable with 68801?

No. Irrigation performed with punctal dilation is included in 68801.

How is bilateral punctal dilation reported?

CMS identifies 68801 as a bilateral procedure; modifier 50 is paid at 150% when both sides are treated.

Are related postoperative visits included?

Yes. Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant or co-surgeon be paid for 68801?

Medicare does not pay an assistant at surgery for this code, and 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 68801PPRRVU2026_Oct_nonQPP.csv, line 7,571 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet