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CMS RVU26D · Effective 2026-10-01

68720 Tear drainage surgery Medicare reimbursement rates in Indiana

Surgical creation of a drainage passage from the lacrimal sac into the nose treats tear outflow obstruction without tube or stent intubation. Compare 68720 office and facility rates across CMS payment localities in Indiana.

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 68720 in Indiana?

Indiana 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

No supported rate

Facility setting

$663.05

1 of 1 localities have a supported rate.

Payment area: Indiana

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.

Find 68720 in your payment locality →

Ophthalmology surgery

About 68720: Dacryocystorhinostomy without intubation

Surgical creation of a drainage passage from the lacrimal sac into the nose treats tear outflow obstruction without tube or stent intubation.

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.

CMS billing rules for 68720

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU9.71 · 46%
  • Practice expense (office) RVU10.51 · 50%
  • Malpractice RVU0.82 · 4%

4.7K

Medicare services in 2024 · #1916 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.

68720 compared with similar codes

Office rates for Indiana, from the same CMS release.

68745

Tear duct bypass

With tube or stent

No office rate

Both describe DCR, but 68745 includes tube or stent insertion; 68720 is the no-intubation service.

68750

Tear drainage bypass

Tube or stent placement

No office rate

68750 creates a conjunctivorhinostomy bypass, while 68720 creates a drainage passage from the lacrimal sac into the nose.

68705

Punctum revision

With reconstruction

$243.41

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.

Compare 68720 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

Office and facility base rates · shared scale starting at $0

  • Indiana →

    Office / nonfacility

    Unavailable

    Facility

    $663.05

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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 68720 in Indiana.

PPRRVU2026_Oct_nonQPP.csv

7,565

Code
68720
Physician work
9.71
Practice expense
10.51
Malpractice
0.82

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Facility calculation for 68720 in Indiana
ComponentRVULocality factorAdjusted
Physician work9.71× 1.0009.7100
Practice expense10.51× 0.9279.7428
Malpractice0.82× 0.4860.3985
Total RVUs19.8513
Conversion factor× 33.4009

Facility rate, Indiana$663.05

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work9.711
Practice expense10.510.927
Malpractice0.820.486

(9.71 × 1 + 10.51 × 0.927 + 0.82 × 0.486) × $33.4009 = $663.05

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.

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 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 68720PPRRVU2026_Oct_nonQPP.csv, line 7,565 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet