FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

68816 in Wyoming**

Office / nonfacility

$830.29

Base rate per service

Facility setting

$132.55

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

About 68816: Nasolacrimal duct balloon dilation

An ophthalmologist probes an obstructed nasolacrimal duct and dilates it with a balloon catheter to improve tear drainage.

This procedure treats obstruction or narrowing in the nasolacrimal duct, the passage that carries tears from the eye into the nose. The ophthalmologist passes a probe through the drainage pathway and uses a balloon catheter to expand the narrowed segment; irrigation may also be performed. It is commonly used for persistent tear-duct obstruction, including congenital obstruction in children, and may be performed in an operating room or another appropriate procedural setting.

Report this code when balloon catheter dilation is performed with probing, rather than probing alone or placement of a tube or stent. The operative note should identify the treated side, the obstruction or narrowing, and the probing and balloon-dilation work performed. The procedure has a 10-day global period, which includes related postoperative visits during that period. 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 others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 68816

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 RVU2.05 · 8%
  • Practice expense (office) RVU22.69 · 91%
  • Malpractice RVU0.16 · 1%

220

Medicare services in 2024 · #4241 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.

68816 compared with similar codes

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

68810

Tear duct probing

Simple probing

$159.62

Choose 68816 when probing includes balloon catheter dilation. For probing without balloon dilation, use the applicable probing code.

68811

Tear duct probing

General anesthesia

No office rate

This is a probing alternative without balloon catheter dilation; 68816 specifically includes balloon dilation.

68815

Duct probing

With tube or stent

$371.26

Choose 68815 when a tube or stent is placed with probing. Choose 68816 when balloon catheter dilation is performed instead.

68801

Punctum dilation

Punctal opening, with or without irrigation

$94.09

68801 addresses dilation at the lacrimal punctum. Code 68816 is for probing and balloon dilation of the nasolacrimal duct.

The same code, a different location

How does Wyoming** compare?

68816 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $830.29

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

    $971.38

    $141.09 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $970.88

    $140.59 higher than Wyoming**

  4. Miami

    $870.93

    $40.64 higher than Wyoming**

  5. Chicago

    $842.87

    $12.58 higher than Wyoming**

  6. Manhattan

    $961.97

    $131.68 higher than Wyoming**

  7. Alaska*

    $912.78

    $82.49 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, 68816 ranges from $722.23 in Arkansas to $1171.71 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 · 68816

    Office

    $734.63

    Facility

    $124.10

    $95.66 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 68816

    Office

    $722.23

    Facility

    $122.87

    $108.06 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 68816

    Office

    $807.42

    Facility

    $131.30

    $22.87 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 68816

    Office

    $903.65

    Facility

    $138.92

    $73.36 higher than Wyoming** for the office setting.

  • Chico

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • El Centro

    California · 68816

    Office

    $903.15

    Facility

    $138.42

    $72.86 higher than Wyoming** for the office setting.

  • Fresno

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Madera

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Merced

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Modesto

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Napa

    California · 68816

    Office

    $1074.37

    Facility

    $154.74

    $244.08 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 68816

    Office

    $969.52

    Facility

    $144.78

    $139.23 higher than Wyoming** for the office setting.

  • Redding

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 68816

    Office

    $904.88

    Facility

    $140.16

    $74.59 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 68816

    Office

    $955.20

    Facility

    $143.72

    $124.91 higher than Wyoming** for the office setting.

  • Salinas

    California · 68816

    Office

    $951.83

    Facility

    $143.14

    $121.54 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 68816

    Office

    $979.83

    Facility

    $145.33

    $149.54 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 68816

    Office

    $1146.02

    Facility

    $162.20

    $315.73 higher than Wyoming** for the office setting.

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

    California · 68816

    Office

    $1145.84

    Facility

    $162.02

    $315.55 higher than Wyoming** for the office setting.

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

    California · 68816

    Office

    $1171.71

    Facility

    $165.56

    $341.42 higher than Wyoming** for the office setting.

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

    California · 68816

    Office

    $1170.97

    Facility

    $164.82

    $340.68 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 68816

    Office

    $935.71

    Facility

    $140.98

    $105.42 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 68816

    Office

    $993.58

    Facility

    $145.82

    $163.29 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 68816

    Office

    $956.93

    Facility

    $143.36

    $126.64 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 68816

    Office

    $1004.05

    Facility

    $147.22

    $173.76 higher than Wyoming** for the office setting.

  • Stockton

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Vallejo

    California · 68816

    Office

    $1074.11

    Facility

    $154.48

    $243.82 higher than Wyoming** for the office setting.

  • Visalia

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Yuba City

    California · 68816

    Office

    $903.12

    Facility

    $138.39

    $72.83 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 68816

    Office

    $879.84

    Facility

    $137.44

    $49.55 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 68816

    Office

    $892.53

    Facility

    $141.06

    $62.24 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 68816

    Office

    $822.39

    Facility

    $133.02

    $7.90 lower than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 68816

    Office

    $845.85

    Facility

    $139.04

    $15.56 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 68816

    Office

    $801.02

    Facility

    $133.98

    $29.27 lower than Wyoming** for the office setting.

  • Atlanta

    Georgia · 68816

    Office

    $845.09

    Facility

    $136.18

    $14.80 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 68816

    Office

    $750.86

    Facility

    $128.47

    $79.43 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 68816

    Office

    $933.26

    Facility

    $139.92

    $102.97 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 68816

    Office

    $764.04

    Facility

    $125.60

    $66.25 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 68816

    Office

    $768.24

    Facility

    $126.31

    $62.05 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 68816

    Office

    $776.47

    Facility

    $134.55

    $53.82 lower than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 68816

    Office

    $768.76

    Facility

    $131.72

    $61.53 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 68816

    Office

    $856.75

    Facility

    $140.17

    $26.46 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 68816

    Office

    $773.61

    Facility

    $126.80

    $56.68 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 68816

    Office

    $756.28

    Facility

    $125.52

    $74.01 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 68816

    Office

    $747.10

    Facility

    $126.81

    $83.19 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 68816

    Office

    $787.70

    Facility

    $131.12

    $42.59 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 68816

    Office

    $744.30

    Facility

    $126.80

    $85.99 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 68816

    Office

    $980.93

    Facility

    $147.82

    $150.64 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 68816

    Office

    $871.86

    Facility

    $137.13

    $41.57 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 68816

    Office

    $889.37

    Facility

    $140.69

    $59.08 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 68816

    Office

    $841.02

    Facility

    $134.91

    $10.73 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 68816

    Office

    $769.03

    Facility

    $127.11

    $61.26 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 68816

    Office

    $822.89

    Facility

    $131.42

    $7.40 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 68816

    Office

    $808.82

    Facility

    $135.50

    $21.47 lower than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 68816

    Office

    $766.44

    Facility

    $129.40

    $63.85 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 68816

    Office

    $849.90

    Facility

    $131.92

    $19.61 higher than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 68816

    Office

    $785.33

    Facility

    $130.15

    $44.96 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 68816

    Office

    $795.32

    Facility

    $131.06

    $34.97 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 68816

    Office

    $726.96

    Facility

    $125.50

    $103.33 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 68816

    Office

    $724.94

    Facility

    $124.19

    $105.35 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 68816

    Office

    $831.67

    Facility

    $133.93

    $1.38 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 68816

    Office

    $778.98

    Facility

    $127.98

    $51.31 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 68816

    Office

    $828.51

    Facility

    $130.76

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

  • Nebraska

    Nebraska · 68816

    Office

    $770.00

    Facility

    $125.98

    $60.29 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 68816

    Office

    $862.09

    Facility

    $135.73

    $31.80 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 68816

    Office

    $957.62

    Facility

    $148.23

    $127.33 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 68816

    Office

    $904.66

    Facility

    $142.73

    $74.37 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 68816

    Office

    $769.85

    Facility

    $130.02

    $60.44 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 68816

    Office

    $831.55

    Facility

    $133.11

    $1.26 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 68816

    Office

    $983.88

    Facility

    $154.26

    $153.59 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 68816

    Office

    $907.88

    Facility

    $143.85

    $77.59 higher than Wyoming** for the office setting.

  • Queens

    New York · 68816

    Office

    $976.36

    Facility

    $151.62

    $146.07 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 68816

    Office

    $792.20

    Facility

    $129.34

    $38.09 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 68816

    Office

    $765.79

    Facility

    $128.75

    $64.50 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 68816

    Office

    $749.40

    Facility

    $126.31

    $80.89 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 68816

    Office

    $915.53

    Facility

    $140.34

    $85.24 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 68816

    Office

    $827.06

    Facility

    $132.11

    $3.23 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 68816

    Office

    $865.02

    Facility

    $138.67

    $34.73 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 68816

    Office

    $769.24

    Facility

    $128.71

    $61.05 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 68816

    Office

    $839.94

    Facility

    $134.52

    $9.65 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 68816

    Office

    $857.42

    Facility

    $136.65

    $27.13 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 68816

    Office

    $773.28

    Facility

    $128.57

    $57.01 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 68816

    Office

    $828.13

    Facility

    $130.39

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

  • Tennessee

    Tennessee · 68816

    Office

    $760.24

    Facility

    $125.99

    $70.05 lower than Wyoming** for the office setting.

  • Austin

    Texas · 68816

    Office

    $875.17

    Facility

    $136.95

    $44.88 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 68816

    Office

    $763.09

    Facility

    $128.15

    $67.20 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 68816

    Office

    $824.23

    Facility

    $132.77

    $6.06 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 68816

    Office

    $828.51

    Facility

    $133.55

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

  • Fort Worth

    Texas · 68816

    Office

    $821.00

    Facility

    $133.02

    $9.29 lower than Wyoming** for the office setting.

  • Galveston

    Texas · 68816

    Office

    $826.01

    Facility

    $133.15

    $4.28 lower than Wyoming** for the office setting.

  • Houston

    Texas · 68816

    Office

    $828.93

    Facility

    $136.07

    $1.36 lower than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 68816

    Office

    $792.51

    Facility

    $130.35

    $37.78 lower than Wyoming** for the office setting.

  • Utah

    Utah · 68816

    Office

    $785.67

    Facility

    $129.79

    $44.62 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 68816

    Office

    $817.23

    Facility

    $131.34

    $13.06 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 68816

    Office

    $839.94

    Facility

    $134.52

    $9.65 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 68816

    Office

    $821.46

    Facility

    $130.70

    $8.83 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 68816

    Office

    $871.46

    Facility

    $136.74

    $41.17 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 68816

    Office

    $1006.16

    Facility

    $150.03

    $175.87 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 68816

    Office

    $796.15

    Facility

    $127.71

    $34.14 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 68816

    Office

    $734.71

    Facility

    $128.37

    $95.58 lower than Wyoming** for the office setting.

See how rates vary across the country

68816 · 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.

$722.23

$1,037.42

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$912.781
AL$734.631
AR$722.231
AZ$807.421
CA$903.12–$1,171.7129
CO$879.841
CT$892.531
DC$970.881
DE$822.391
FL$801.02–$870.933
GA$750.86–$845.092
GU$933.261
HI$933.261
IA$764.041
ID$768.241
IL$768.76–$856.754
IN$773.611
KS$756.281
KY$747.101
LA$744.30–$787.702
MA$871.86–$980.932
MD$841.02–$970.883
ME$769.03–$822.892
MI$766.44–$808.822
MN$849.901
MO$726.96–$795.323
MS$724.941
MT$831.671
NC$778.981
ND$828.511
NE$770.001
NH$862.091
NJ$904.66–$957.622
NM$769.851
NV$831.551
NY$792.20–$983.885
OH$765.791
OK$749.401
OR$827.06–$915.532
PA$769.24–$865.022
PR$839.941
RI$857.421
SC$773.281
SD$828.131
TN$760.241
TX$763.09–$875.178
UT$785.671
VA$817.23–$970.882
VI$839.941
VT$821.461
WA$871.46–$1,006.162
WI$796.151
WV$734.711
WY$830.291

Explore 68816 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 68816 in Wyoming**, the physician’s office rate is $830.29 and the facility-setting rate is $132.55: a difference of $697.74.

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 68816 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$913.32

$830.29 × 110% = $913.32

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 68816 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

7,575

Code
68816
Physician work
2.05
Practice expense
22.69
Malpractice
0.16

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 68816 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work2.05× 1.0002.0500
Practice expense22.69× 1.00022.6900
Malpractice0.16× 0.7400.1184
Total RVUs24.8584
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$830.29

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

Open 68816 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.051
Practice expense22.691
Malpractice0.160.74

(2.05 × 1 + 22.69 × 1 + 0.16 × 0.74) × $33.4009 = $830.29

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.051
Practice expense1.81
Malpractice0.160.74

(2.05 × 1 + 1.8 × 1 + 0.16 × 0.74) × $33.4009 = $132.55

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

68816 · Office / nonfacility

$830.29

Effective 2026-10-01

The base rate is $50.80 higher than on 2025-10-01, moving from $779.49 to $830.29 (6.5%).

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

    $779.49changed to$830.29

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.10 changed to 2.05
    • Practice expense RVU 21.88 changed to 22.69
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $779.49

    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$830.29$132.55RVU26D
2026-07-01$830.29$132.55RVU26C
2026-04-01$830.29$132.55RVU26B
2026-01-01$830.29$132.55RVU26A
2025-10-01$779.49$149.71RVU25D
2025-07-01$779.49$149.71RVU25C
2025-04-01$779.49$149.71RVU25B
2025-01-01$779.49$149.71RVU25A

68816 billing questions

When should I report this instead of 68810?

Use 68816 when the surgeon performs balloon catheter dilation along with probing. Probing without balloon dilation is reported with the applicable probing code.

How does 68816 differ from 68815?

68816 describes balloon catheter dilation with probing; 68815 is used when probing includes placement of a tube or stent. Select the code for the technique actually performed.

Can I report irrigation separately?

Irrigation may be performed as part of the probing service. Do not separately report a service solely for irrigation performed as part of this procedure.

How should bilateral treatment be reported?

For treatment of both nasolacrimal ducts, report modifier 50. CMS pays bilateral procedures at 150%.

What postoperative care is included?

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

Can an assistant or co-surgeon be paid for this procedure?

CMS does not pay 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 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 68816PPRRVU2026_Oct_nonQPP.csv, line 7,575 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet