Billing code 68505: Lacrimal gland surgeryMedicare rate & RVUs in Oregon
Reports surgical removal of part of the lacrimal gland, rather than a diagnostic biopsy or excision of the entire gland.
CMS doesn’t publish an office rate for 68505 in Oregon.
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 68505 covers
An ophthalmic surgeon, often an oculoplastic surgeon, removes a portion of the lacrimal gland in the upper outer orbit. The operation may address disease involving part of the gland or obtain more tissue than a limited diagnostic biopsy. It is generally performed in an operating-room setting; the operative report should identify the gland, the extent removed, the indication, and laterality.
Report this code when the surgeon removes part, but not all, of the lacrimal gland. A biopsy is a separate choice when the service is tissue sampling for diagnosis; complete gland removal and excision of a discrete gland lesion have their own codes. This major surgery includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral surgery reported with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this code; 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 68505 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $967.86 |
| Rest Of Oregon | Unavailable | $905.72 |
How the 68505 rate is calculated
Each of 68505’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 · 68505
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.37Practice expense 14.10Malpractice 1.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 68505
68505 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68505
Lacrimal gland surgery
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 68505
Lacrimal gland surgery
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68505 without 50 · national facility
$917.52
Lacrimal gland surgery
68505-50 · Bilateral: 150%
$1,376.28
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).
68505 compared with similar codes
Compare codes
68505 vs 68500 vs 68510 vs 68540: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 68500Lacrimal gland surgery
- 68505 describes removal of part of the gland; 68500 is for removal of the gland rather than a partial resection.
- 68510Lacrimal biopsy
- Choose 68510 for diagnostic biopsy sampling. Choose 68505 when the surgeon removes a portion of the gland.
- 68540Lacrimal lesion excision
- 68540 is for excision of a discrete lacrimal gland lesion; 68505 describes partial removal of the gland itself.
68505 billing questions
How is partial gland excision different from a lacrimal gland biopsy?
Report 68505 when the surgeon removes part of the gland. Use 68510 when the service is a biopsy for diagnostic tissue sampling.
When would complete gland removal be reported instead?
Use 68500 when the surgeon removes the lacrimal gland rather than only a portion. The operative report should support the extent of removal.
Is related postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral partial gland excision reported?
Report bilateral surgery with modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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 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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