Billing code 68400: Lacrimal gland drainageMedicare rate & RVUs in Oregon
Reports surgical drainage of an infected collection in the lacrimal gland, typically performed by an ophthalmologist for a gland abscess.
Medicare pays $293.61–$321.67 for 68400 in the office in Oregon, from Rest Of Oregon to Portland. 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 68400 covers
An ophthalmologist, often an oculoplastic surgeon, uses this service to open and drain a collection within the lacrimal gland, such as an abscess associated with acute dacryoadenitis. The procedure addresses the gland itself, which sits in the upper outer part of the orbit; it is not drainage of the lacrimal sac or treatment of a narrowed punctum. It may be performed in an office or a facility, depending on the clinical circumstances and surgical setting.
Report the code when the operative documentation supports incision and drainage of the lacrimal gland, rather than treatment of another lacrimal structure. The 10-day global period includes related postoperative visits during that period. When other procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral gland drainage, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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.
Where 68400 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $321.67 | $118.32 |
| Rest Of Oregon | $293.61 | $111.30 |
How the 68400 rate is calculated
Each of 68400’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 · 68400
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.70Practice expense 7.02Malpractice 0.14
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 68400
68400 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68400
Lacrimal gland drainage
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 68400
Lacrimal gland drainage
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
68400 without 50 · national office
$295.93
Lacrimal gland drainage
68400-50 · Bilateral: 150%
$443.90
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).
68400 compared with similar codes
Compare codes
68400 vs 68420 vs 68440 vs 68500: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 68420Lacrimal drainage
- Choose 68400 for a collection in the lacrimal gland and 68420 for a collection in the lacrimal sac. The documented anatomic site determines the code.
- 68440Punctal incision
- 68440 is a snip incision of the lacrimal punctum, not drainage of a lacrimal gland abscess.
- 68500Lacrimal gland surgery
- 68400 drains a collection while preserving the gland; 68500 describes excision of the lacrimal gland.
68400 billing questions
How is this different from 68420?
68400 is for drainage of the lacrimal gland. Use 68420 when the incision and drainage is of the lacrimal sac instead.
Does the 10-day global period include postoperative visits?
Yes. Related postoperative visits during the 10 days after the procedure are included.
How is bilateral lacrimal gland drainage reported?
Use modifier 50 when both glands are treated. CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting this code?
Document the lacrimal gland as the treated site and describe the incision and drainage performed. The record should distinguish gland drainage from treatment of the lacrimal sac or punctum.
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
Fee sheets
Put 68400 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →