$173.57
Choose 68530 for removal of obstructing material. Choose 68810 when the documented service is probing the nasolacrimal duct, with or without irrigation.
On this page
CMS RVU26D · Effective 2026-10-01
68530 Tear duct clearance Medicare reimbursement rates in Hawaii
Removal of obstructing material from the lacrimal drainage duct, reported when a tear duct concretion or similar blockage is cleared. Compare 68530 office and facility rates across CMS payment localities in Hawaii.
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.
What does Medicare pay for 68530 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$471.20
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$220.17
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmology
About 68530: Lacrimal duct obstruction clearance
Removal of obstructing material from the lacrimal drainage duct, reported when a tear duct concretion or similar blockage is cleared.
This procedure clears obstructing material, such as a dacryolith, from the lacrimal drainage duct. Ophthalmologists, including oculoplastic surgeons, perform it for patients with tear drainage blockage that may cause persistent tearing or recurrent inflammation. The service concerns removal of the obstruction, rather than simple probing or placement of a drainage tube.
Report the code when the operative record supports actual clearance of obstructing material from the duct; document the site and what was removed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 68530
- 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 RVU3.61 · 28%
- Practice expense (office) RVU9.09 · 70%
- Malpractice RVU0.28 · 2%
2.4K
Medicare services in 2024 · #2340 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.
68530 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$408.25
Code 68815 describes probing with tube or stent insertion. It differs from 68530, which represents clearance of obstruction rather than duct intubation.
No office rate
Code 68720 creates a new drainage route between the lacrimal sac and nose. Code 68530 clears material from the existing duct.
Compare 68530 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$471.20
Facility
$220.17
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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 68530 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,560
- Code
- 68530
- Physician work
- 3.61
- Practice expense
- 9.09
- Malpractice
- 0.28
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.61 | × 1.000 | 3.6100 |
| Practice expense | 9.09 | × 1.137 | 10.3353 |
| Malpractice | 0.28 | × 0.579 | 0.1621 |
| Total RVUs | 14.1075 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$471.20
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.61 | 1 |
| Practice expense | 9.09 | 1.137 |
| Malpractice | 0.28 | 0.579 |
(3.61 × 1 + 9.09 × 1.137 + 0.28 × 0.579) × $33.4009 = $471.20
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.61 | 1 |
| Practice expense | 2.48 | 1.137 |
| Malpractice | 0.28 | 0.579 |
(3.61 × 1 + 2.48 × 1.137 + 0.28 × 0.579) × $33.4009 = $220.17
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.
68530 billing questions
When is this code more appropriate than probing the nasolacrimal duct?
Use 68530 when the service clears obstructing material from the lacrimal duct. Probing under 68810 describes probing, with or without irrigation, rather than removal of a concretion.
Does placing a lacrimal tube change the code choice?
When probing includes insertion of a tube or stent, compare the service with 68815. The operative documentation should show whether the work was obstruction removal or probing with intubation.
How should bilateral treatment be reported?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant surgeon or co-surgeon be reported?
CMS 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.
7,55768510,,Biopsy of tear gland,A,,4.49,8.65,,2.18,,0.36,13.50,7.03,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55868520,,Removal of tear sac,A,,8.56,10.00,NA,10.00,,0.71,19.27,19.27,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55968525,,Biopsy of tear sac,A,,4.31,1.51,NA,1.51,,0.36,6.18,6.18,0,000,0.00,0.00,0.00,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56068530,,Clearance of tear duct,A,,3.61,9.09,,2.48,,0.28,12.98,6.37,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56168540,,Remove tear gland lesion,A,,11.88,12.54,NA,12.54,,0.95,25.37,25.37,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56268550,,Remove tear gland lesion,A,,14.78,15.57,NA,15.57,,1.19,31.54,31.54,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56368700,,Repair tear ducts,A,,7.67,7.17,NA,7.17,,0.62,15.46,15.46,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014