No office rate
68505 describes removal of part of the gland; 68500 is for removal of the gland rather than a partial resection.
On this page
CMS RVU26D · Effective 2026-10-01
68505 Lacrimal gland surgery Medicare reimbursement rates in Virginia
Reports surgical removal of part of the lacrimal gland, rather than a diagnostic biopsy or excision of the entire gland. Compare 68505 office and facility rates across CMS payment localities in Virginia.
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 68505 in Virginia?
Virginia 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
$899.70–$1027.44
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.
Ophthalmology surgery
About 68505: Partial lacrimal gland excision
Reports surgical removal of part of the lacrimal gland, rather than a diagnostic biopsy or excision of the entire gland.
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.
CMS billing rules for 68505
- 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
- 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 RVU12.37 · 45%
- Practice expense (office) RVU14.10 · 51%
- Malpractice RVU1.00 · 4%
33
Medicare services in 2024 · #5605 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.
68505 compared with similar codes
Office rates for Virginia, from the same CMS release.
$442.47–$511.80
Choose 68510 for diagnostic biopsy sampling. Choose 68505 when the surgeon removes a portion of the gland.
No office rate
68540 is for excision of a discrete lacrimal gland lesion; 68505 describes partial removal of the gland itself.
Compare 68505 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1027.44
Virginia →
Office / nonfacility
Unavailable
Facility
$899.70
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
7,55368420,,I&d lacrimal sac,A,,2.29,7.43,,1.75,,0.18,9.90,4.22,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55468440,,Snip inc lacrimal punctum,A,,0.97,2.14,,1.68,,0.07,3.18,2.72,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55568500,,Removal of tear gland,A,,12.45,14.12,NA,14.12,,1.01,27.58,27.58,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55668505,,Partial removal tear gland,A,,12.37,14.10,NA,14.10,,1.00,27.47,27.47,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,55768510,,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