68801 is for dilation of the lacrimal punctum. With 68841, dilation needed to place the drug-eluting implant is included.
On this page
CMS RVU26D · Effective 2026-10-01
68841 Lacrimal implant Medicare reimbursement rates in Virginia
Reports placement of a drug-eluting implant in a lacrimal canaliculus, commonly to deliver sustained medication after ophthalmic surgery. Compare 68841 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 68841 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
$37.99–$43.57
2 of 2 localities have a supported rate.
Facility setting
$26.83–$30.19
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
About 68841: Drug-eluting lacrimal implant placement
Reports placement of a drug-eluting implant in a lacrimal canaliculus, commonly to deliver sustained medication after ophthalmic surgery.
An ophthalmologist places a medication-releasing insert into the lacrimal canaliculus, the small channel connecting the eyelid punctum to the tear drainage system. Punctal dilation needed for insertion is included. A common use is delivering sustained medication for ocular inflammation or pain after cataract surgery; placement may occur in an office or during a surgical encounter.
Report the service for each treated canaliculus and document the eye, implant placement, and clinical indication. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 68841
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU0.48 · 41%
- Practice expense (office) RVU0.64 · 55%
- Malpractice RVU0.04 · 3%
91.2K
Medicare services in 2024 · #589 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.
68841 compared with similar codes
Office rates for Virginia, from the same CMS release.
68810 probes the nasolacrimal duct; it addresses tear-drainage patency rather than medication implant placement.
68815 probes the nasolacrimal duct, with or without irrigation. It is a duct procedure, not placement of a drug-eluting canalicular implant.
68840 explores or irrigates the lacrimal canaliculi. Choose it for canalicular evaluation or irrigation, not implant delivery.
Compare 68841 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
$43.57
Facility
$30.19
Virginia →
Office / nonfacility
$37.99
Facility
$26.83
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68841 billing questions
Is punctal dilation separately reported with 68841?
Punctal dilation performed to place the implant is included in 68841. The code is for the implant placement, not dilation alone.
How is bilateral implant placement reported?
CMS identifies 68841 as bilateral and pays modifier 50 at 150%. Document the treated eyes and implant placements.
Can 68841 be reported with cataract surgery?
It may be performed during the same encounter as cataract surgery when the implant is placed for a separate medication-delivery purpose. The standard multiple procedure reduction applies when multiple procedures are performed in the same session.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
What documentation supports 68841?
Record the medication-releasing implant placement, the treated eye or canaliculus, and the clinical reason for sustained medication delivery.
Can an assistant or co-surgeon be paid for 68841?
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.
