Billing code 68761: Punctal occlusionMedicare rate & RVUs in Delaware
Reports plug-based closure of a lacrimal punctum, commonly to retain tears in patients with aqueous-deficient dry eye.
Medicare pays $142.14 for 68761 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 68761 covers
An ophthalmologist places a plug in a lacrimal punctum to reduce tear drainage and help retain the eye’s natural tears. This is commonly performed in an office for patients with dry eye related to inadequate tear volume. The code represents treatment of each punctum, rather than a permanent closure technique or surgery to restore tear drainage.
Report the code for each punctum treated and document the indication, site and number of puncta, and plug placement. For bilateral treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%. A 10-day global period includes related postoperative visits during that period. If multiple procedures subject to the standard multiple-procedure rule are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are 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.
68761 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $142.14 | $102.87 |
How the 68761 rate is calculated
Each of 68761’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 · 68761
RVUs × geographic indexes × conversion factor
Work1.37
1.37 RVUs× 1.000 GPCI
Practice expense2.85
2.85 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
4.2900
Conversion factor
$33.4009
Medicare rate
$143.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 68761
68761 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68761
Punctal occlusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68761
Punctal occlusion
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68761 without 50 · national office
$143.29
Punctal occlusion
68761-50 · Bilateral: 150%
$214.94
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).
68761 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 68760Punctal closure
- Choose 68761 for plug-based closure; choose 68760 when the punctum is closed by a method such as cauterization or ligation.
- 68705Punctum revision
- This code occludes a punctum to retain tears. Code 68705 revises the punctum, such as when a narrowed opening needs revision rather than closure.
- 68770Lacrimal fistula closure
- This code treats a lacrimal punctum with a plug. Code 68770 addresses closure of a fistula involving the lacrimal system.
68761 billing questions
How does this differ from 68760?
This code is for plug-based punctal closure. Code 68760 is used when the punctum is closed by a method such as cauterization or ligation.
How many units should be reported?
The code represents each punctum treated. Document the punctum or puncta where plugs were placed.
How is bilateral treatment reported?
Use modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Are related postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included.
What documentation supports reporting this service?
Document the tear-retention indication, the treated punctum or puncta, and that plug placement was performed.
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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