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CMS RVU26D · Effective 2026-10-01

68400 in Wyoming**

Office / nonfacility

$294.72

Base rate per service

Facility setting

$111.68

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 68400: Lacrimal gland abscess drainage

Reports surgical drainage of an infected collection in the lacrimal gland, typically performed by an ophthalmologist for a gland abscess.

An ophthalmologist, often an oculoplastic surgeon, uses this service to open and drain a collection within the lacrimal gland, such as an abscess associated with acute dacryoadenitis. The procedure addresses the gland itself, which sits in the upper outer part of the orbit; it is not drainage of the lacrimal sac or treatment of a narrowed punctum. It may be performed in an office or a facility, depending on the clinical circumstances and surgical setting.

Report the code when the operative documentation supports incision and drainage of the lacrimal gland, rather than treatment of another lacrimal structure. The 10-day global period includes related postoperative visits during that period. When other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral gland drainage, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 68400

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 RVU1.70 · 19%
  • Practice expense (office) RVU7.02 · 79%
  • Malpractice RVU0.14 · 2%

44

Medicare services in 2024 · #5441 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.

68400 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

68420

Lacrimal drainage

Lacrimal sac abscess

$329.11

Choose 68400 for a collection in the lacrimal gland and 68420 for a collection in the lacrimal sac. The documented anatomic site determines the code.

68440

Punctal incision

Snip enlargement

$105.61

68440 is a snip incision of the lacrimal punctum, not drainage of a lacrimal gland abscess.

68500

Lacrimal gland surgery

Complete gland removal

No office rate

68400 drains a collection while preserving the gland; 68500 describes excision of the lacrimal gland.

The same code, a different location

How does Wyoming** compare?

68400 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $294.72

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

    $339.60

    $44.88 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $341.26

    $46.54 higher than Wyoming**

  4. Miami

    $312.70

    $17.98 higher than Wyoming**

  5. Chicago

    $303.56

    $8.84 higher than Wyoming**

  6. Manhattan

    $340.29

    $45.57 higher than Wyoming**

  7. Alaska*

    $337.46

    $42.74 higher than Wyoming**

Other payment areas listed in Wyoming 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, 68400 ranges from $260.60 in Arkansas to $403.65 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

  • Alabama

    Alabama · 68400

    Office

    $264.59

    Facility

    $104.44

    $30.13 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 68400

    Office

    $260.60

    Facility

    $103.37

    $34.12 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 68400

    Office

    $287.99

    Facility

    $110.63

    $6.73 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 68400

    Office

    $317.69

    Facility

    $117.08

    $22.97 higher than Wyoming** for the office setting.

  • Chico

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • El Centro

    California · 68400

    Office

    $317.26

    Facility

    $116.65

    $22.54 higher than Wyoming** for the office setting.

  • Fresno

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Madera

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Merced

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Modesto

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Napa

    California · 68400

    Office

    $371.77

    Facility

    $130.53

    $77.05 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 68400

    Office

    $338.43

    Facility

    $122.08

    $43.71 higher than Wyoming** for the office setting.

  • Redding

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 68400

    Office

    $318.78

    Facility

    $118.17

    $24.06 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 68400

    Office

    $334.03

    Facility

    $121.15

    $39.31 higher than Wyoming** for the office setting.

  • Salinas

    California · 68400

    Office

    $332.80

    Facility

    $120.66

    $38.08 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 68400

    Office

    $341.45

    Facility

    $122.54

    $46.73 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 68400

    Office

    $394.93

    Facility

    $136.85

    $100.21 higher than Wyoming** for the office setting.

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

    California · 68400

    Office

    $394.77

    Facility

    $136.69

    $100.05 higher than Wyoming** for the office setting.

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

    California · 68400

    Office

    $403.65

    Facility

    $139.71

    $108.93 higher than Wyoming** for the office setting.

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

    California · 68400

    Office

    $403.00

    Facility

    $139.06

    $108.28 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 68400

    Office

    $327.32

    Facility

    $118.84

    $32.60 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 68400

    Office

    $345.37

    Facility

    $122.98

    $50.65 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 68400

    Office

    $334.27

    Facility

    $120.85

    $39.55 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 68400

    Office

    $348.93

    Facility

    $124.16

    $54.21 higher than Wyoming** for the office setting.

  • Stockton

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Vallejo

    California · 68400

    Office

    $371.54

    Facility

    $130.30

    $76.82 higher than Wyoming** for the office setting.

  • Visalia

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Yuba City

    California · 68400

    Office

    $317.24

    Facility

    $116.63

    $22.52 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 68400

    Office

    $310.60

    Facility

    $115.84

    $15.88 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 68400

    Office

    $316.10

    Facility

    $118.97

    $21.38 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 68400

    Office

    $292.93

    Facility

    $112.09

    $1.79 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 68400

    Office

    $302.76

    Facility

    $117.34

    $8.04 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 68400

    Office

    $287.97

    Facility

    $112.98

    $6.75 lower than Wyoming** for the office setting.

  • Atlanta

    Georgia · 68400

    Office

    $300.79

    Facility

    $114.83

    $6.07 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 68400

    Office

    $271.51

    Facility

    $108.24

    $23.21 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 68400

    Office

    $326.09

    Facility

    $117.97

    $31.37 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 68400

    Office

    $273.18

    Facility

    $105.70

    $21.54 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 68400

    Office

    $274.71

    Facility

    $106.32

    $20.01 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 68400

    Office

    $281.92

    Facility

    $113.52

    $12.80 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 68400

    Office

    $278.17

    Facility

    $111.05

    $16.55 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 68400

    Office

    $306.27

    Facility

    $118.29

    $11.55 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 68400

    Office

    $276.41

    Facility

    $106.74

    $18.31 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 68400

    Office

    $271.10

    Facility

    $105.64

    $23.62 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 68400

    Office

    $269.51

    Facility

    $106.79

    $25.21 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 68400

    Office

    $282.73

    Facility

    $110.50

    $11.99 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 68400

    Office

    $268.77

    Facility

    $106.78

    $25.95 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 68400

    Office

    $343.23

    Facility

    $124.69

    $48.51 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 68400

    Office

    $308.32

    Facility

    $115.58

    $13.60 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 68400

    Office

    $315.07

    Facility

    $118.67

    $20.35 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 68400

    Office

    $298.93

    Facility

    $113.70

    $4.21 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 68400

    Office

    $275.41

    Facility

    $107.01

    $19.31 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 68400

    Office

    $292.10

    Facility

    $110.71

    $2.62 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 68400

    Office

    $290.93

    Facility

    $114.30

    $3.79 lower than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 68400

    Office

    $276.14

    Facility

    $109.02

    $18.58 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 68400

    Office

    $299.44

    Facility

    $111.09

    $4.72 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 68400

    Office

    $281.52

    Facility

    $109.65

    $13.20 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 68400

    Office

    $284.69

    Facility

    $110.44

    $10.03 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 68400

    Office

    $263.45

    Facility

    $105.68

    $31.27 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 68400

    Office

    $262.12

    Facility

    $104.52

    $32.60 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 68400

    Office

    $295.92

    Facility

    $112.89

    $1.20 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 68400

    Office

    $278.53

    Facility

    $107.76

    $16.19 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 68400

    Office

    $293.15

    Facility

    $110.12

    $1.57 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 68400

    Office

    $274.97

    Facility

    $106.03

    $19.75 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 68400

    Office

    $304.96

    Facility

    $114.42

    $10.24 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 68400

    Office

    $337.34

    Facility

    $125.02

    $42.62 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 68400

    Office

    $320.23

    Facility

    $120.35

    $25.51 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 68400

    Office

    $277.41

    Facility

    $109.57

    $17.31 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 68400

    Office

    $295.39

    Facility

    $112.17

    $0.67 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 68400

    Office

    $347.89

    Facility

    $130.26

    $53.17 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 68400

    Office

    $321.74

    Facility

    $121.32

    $27.02 higher than Wyoming** for the office setting.

  • Queens

    New York · 68400

    Office

    $344.31

    Facility

    $127.96

    $49.59 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 68400

    Office

    $282.82

    Facility

    $108.93

    $11.90 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 68400

    Office

    $275.57

    Facility

    $108.46

    $19.15 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 68400

    Office

    $269.80

    Facility

    $106.35

    $24.92 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 68400

    Office

    $321.67

    Facility

    $118.32

    $26.95 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 68400

    Office

    $293.61

    Facility

    $111.30

    $1.11 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 68400

    Office

    $307.47

    Facility

    $116.93

    $12.75 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 68400

    Office

    $276.45

    Facility

    $108.42

    $18.27 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 68400

    Office

    $298.44

    Facility

    $113.39

    $3.72 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 68400

    Office

    $304.24

    Facility

    $115.17

    $9.52 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 68400

    Office

    $277.41

    Facility

    $108.28

    $17.31 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 68400

    Office

    $292.83

    Facility

    $109.79

    $1.89 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 68400

    Office

    $272.43

    Facility

    $106.05

    $22.29 lower than Wyoming** for the office setting.

  • Austin

    Texas · 68400

    Office

    $309.11

    Facility

    $115.46

    $14.39 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 68400

    Office

    $274.50

    Facility

    $107.93

    $20.22 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 68400

    Office

    $293.25

    Facility

    $111.86

    $1.47 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 68400

    Office

    $294.84

    Facility

    $112.54

    $0.12 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 68400

    Office

    $292.56

    Facility

    $112.08

    $2.16 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 68400

    Office

    $293.94

    Facility

    $112.18

    $0.78 lower than Wyoming** for the office setting.

  • Houston

    Texas · 68400

    Office

    $296.50

    Facility

    $114.75

    $1.78 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 68400

    Office

    $283.52

    Facility

    $109.82

    $11.20 lower than Wyoming** for the office setting.

  • Utah

    Utah · 68400

    Office

    $281.39

    Facility

    $109.33

    $13.33 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 68400

    Office

    $290.57

    Facility

    $110.65

    $4.15 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 68400

    Office

    $298.44

    Facility

    $113.39

    $3.72 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 68400

    Office

    $291.28

    Facility

    $110.07

    $3.44 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 68400

    Office

    $307.98

    Facility

    $115.24

    $13.26 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 68400

    Office

    $351.14

    Facility

    $126.55

    $56.42 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 68400

    Office

    $282.85

    Facility

    $107.50

    $11.87 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 68400

    Office

    $267.23

    Facility

    $108.17

    $27.49 lower than Wyoming** for the office setting.

See how rates vary across the country

68400 · 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.

$260.60

$360.45

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$337.461
AL$264.591
AR$260.601
AZ$287.991
CA$317.24–$403.6529
CO$310.601
CT$316.101
DC$341.261
DE$292.931
FL$287.97–$312.703
GA$271.51–$300.792
GU$326.091
HI$326.091
IA$273.181
ID$274.711
IL$278.17–$306.274
IN$276.411
KS$271.101
KY$269.511
LA$268.77–$282.732
MA$308.32–$343.232
MD$298.93–$341.263
ME$275.41–$292.102
MI$276.14–$290.932
MN$299.441
MO$263.45–$284.693
MS$262.121
MT$295.921
NC$278.531
ND$293.151
NE$274.971
NH$304.961
NJ$320.23–$337.342
NM$277.411
NV$295.391
NY$282.82–$347.895
OH$275.571
OK$269.801
OR$293.61–$321.672
PA$276.45–$307.472
PR$298.441
RI$304.241
SC$277.411
SD$292.831
TN$272.431
TX$274.50–$309.118
UT$281.391
VA$290.57–$341.262
VI$298.441
VT$291.281
WA$307.98–$351.142
WI$282.851
WV$267.231
WY$294.721

Explore 68400 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 68400 in Wyoming**, the physician’s office rate is $294.72 and the facility-setting rate is $111.68: a difference of $183.04.

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 68400 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$324.19

$294.72 × 110% = $324.19

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.

Compare your contract offer →

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 68400 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

7,552

Code
68400
Physician work
1.70
Practice expense
7.02
Malpractice
0.14

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 68400 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work1.70× 1.0001.7000
Practice expense7.02× 1.0007.0200
Malpractice0.14× 0.7400.1036
Total RVUs8.8236
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$294.72

Open 68400 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.71
Practice expense7.021
Malpractice0.140.74

(1.7 × 1 + 7.02 × 1 + 0.14 × 0.74) × $33.4009 = $294.72

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.71
Practice expense1.541
Malpractice0.140.74

(1.7 × 1 + 1.54 × 1 + 0.14 × 0.74) × $33.4009 = $111.68

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

68400 · Office / nonfacility

$294.72

Effective 2026-10-01

The base rate is $15.22 higher than on 2025-10-01, moving from $279.50 to $294.72 (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

    $279.50changed to$294.72

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.74 changed to 1.70
    • Practice expense RVU 6.79 changed to 7.02
    • Malpractice RVU 0.15 changed to 0.14
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $279.50

    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$294.72$111.68RVU26D
2026-07-01$294.72$111.68RVU26C
2026-04-01$294.72$111.68RVU26B
2026-01-01$294.72$111.68RVU26A
2025-10-01$279.50$125.86RVU25D
2025-07-01$279.50$125.86RVU25C
2025-04-01$279.50$125.86RVU25B
2025-01-01$279.50$125.86RVU25A

68400 billing questions

How is this different from 68420?

68400 is for drainage of the lacrimal gland. Use 68420 when the incision and drainage is of the lacrimal sac instead.

Does the 10-day global period include postoperative visits?

Yes. Related postoperative visits during the 10 days after the procedure are included.

How is bilateral lacrimal gland drainage reported?

Use modifier 50 when both glands are treated. CMS pays the bilateral procedure at 150%.

Can an assistant surgeon or co-surgeon be reported?

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

What documentation supports reporting this code?

Document the lacrimal gland as the treated site and describe the incision and drainage performed. The record should distinguish gland drainage from treatment of the lacrimal sac or punctum.

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 68400PPRRVU2026_Oct_nonQPP.csv, line 7,552 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet