CPT code 68720: Tear drainage surgery2026 Medicare rate & RVUs in Connecticut
Surgical creation of a drainage passage from the lacrimal sac into the nose treats tear outflow obstruction without tube or stent intubation.
CMS doesn’t publish an office rate for 68720 in Connecticut.
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 9 sections
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.
68720 in Connecticut
| Payment locality | Office | Facility |
|---|---|---|
| Connecticut | Unavailable | $742.02 |
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
Work9.71
9.71 RVUs× 1.000 GPCI
Practice expense10.51
10.51 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
21.0400
Conversion factor
$33.4009
Medicare rate
$702.75
Every GPCI starts 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share 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.
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).
68720 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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