$227.73–$251.70
This code closes the lacrimal punctum by a destructive or ligating method. Choose 68770 when the operative target is an abnormal fistula of the lacrimal system.
On this page
CMS RVU26D · Effective 2026-10-01
68770 Lacrimal fistula closure Medicare reimbursement rates in Massachusetts
Reports surgical closure of an abnormal fistulous tract involving the lacrimal system, such as a persistent channel causing tear drainage onto the skin. Compare 68770 office and facility rates across CMS payment localities in Massachusetts.
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 68770 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$548.34–$591.50
2 of 2 localities have a supported rate.
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.
Lacrimal surgery
About 68770: Surgical closure of lacrimal fistula
Reports surgical closure of an abnormal fistulous tract involving the lacrimal system, such as a persistent channel causing tear drainage onto the skin.
An ophthalmologist, often an oculoplastic surgeon, uses this service to close an abnormal communication involving the tear drainage system. A typical presentation is persistent tear-like drainage through an opening near the eye or onto the face. The procedure is performed in an operative setting, with the operative report identifying the fistula site and describing its closure. It is distinct from closing a normal lacrimal punctum to reduce tearing.
Report 68770 when the treated problem is a lacrimal-system fistula, not a punctal opening or a damaged canaliculus. Documentation should establish the abnormal tract, its location, and the surgical work performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery reporting are not permitted.
CMS billing rules for 68770
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.08 · 50%
- Practice expense (office) RVU7.31 · 46%
- Malpractice RVU0.64 · 4%
59
Medicare services in 2024 · #5261 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.
68770 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$148.59–$163.38
This code closes the lacrimal punctum with a plug. It does not describe surgical closure of a fistulous tract.
No office rate
This code repairs the lacrimal canaliculi. Use 68770 when the documented problem is a fistula rather than canalicular damage.
No office rate
This code creates a drainage route between the lacrimal sac and the nose. Code 68770 closes an abnormal lacrimal fistula.
Compare 68770 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$591.50
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$548.34
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68770 billing questions
When should 68770 be chosen over lacrimal punctum closure?
Use 68770 for surgical closure of an abnormal fistulous tract involving the lacrimal system. Codes 68760 and 68761 address closure of the lacrimal punctum, not a fistula.
What documentation supports 68770?
The record should identify the abnormal fistula and its location, describe the operative closure, and support that the work treated a fistulous tract rather than a punctum or canaliculus.
How is bilateral treatment reported?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150% when both sides are treated.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is available only with documentation of medical necessity. CMS does not permit co-surgeon or team-surgery reporting for this code.
How does CMS handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction.
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.
7,56768750,,Create tear duct drain,A,,9.85,11.75,NA,11.75,,0.82,22.42,22.42,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56868760,,Close tear duct opening,A,,1.74,4.69,,1.94,,0.14,6.57,3.82,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56968761,,Close tear duct opening,A,,1.37,2.85,,1.66,,0.07,4.29,3.10,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57068770,,Close tear system fistula,A,,8.08,7.31,NA,7.31,,0.64,16.03,16.03,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57168801,,Dilate tear duct opening,A,,0.80,1.98,,1.30,,0.05,2.83,2.15,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57268810,,Probe nasolacrimal duct,A,,1.50,3.19,,1.74,,0.12,4.81,3.36,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57368811,,Probe nasolacrimal duct,A,,1.70,1.67,NA,1.67,,0.15,3.52,3.52,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00