Billing code 68760: Punctal closureMedicare rate & RVUs in Washington
Reports closure of a lacrimal punctum by cautery, ligation, or another method to reduce tear drainage, commonly for patients with dry eye.
Medicare pays $227.38–$257.05 for 68760 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 68760 covers
An ophthalmologist, often an oculoplastic specialist, closes a lacrimal punctum to slow tear drainage and retain tears on the eye. This is commonly considered for patients with dry eye when punctal occlusion is needed and a plug is not the selected method. The clinician may use cautery, ligation, or another closure technique, typically in an office setting.
Report this code for punctal closure by a method other than a plug; the plug method is represented separately. Document the treated punctum or side, the technique, and the clinical reason for reducing tear drainage. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; 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 68760 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $227.38 | $130.66 |
| Seattle (King Cnty) | $257.05 | $144.35 |
How the 68760 rate is calculated
Each of 68760’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 · 68760
RVUs × geographic indexes × conversion factor
Work1.74
1.74 RVUs× 1.000 GPCI
Practice expense4.69
4.69 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
6.5700
Conversion factor
$33.4009
Medicare rate
$219.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 68760
68760 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 68760
Punctal closure
| 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 · 68760
Punctal closure
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
68760 without 50 · national office
$219.44
Punctal closure
68760-50 · Bilateral: 150%
$329.16
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).
68760 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 68761Punctal occlusion
- Choose 68760 for closure by cautery, ligation, or another non-plug method. Choose 68761 when a plug is used; that code is reported per punctum.
- 68705Punctum revision
- Both may reduce tear drainage, but 68760 specifically closes the punctum. Code 68705 describes a different procedure for correcting excessive tearing.
- 68770Lacrimal fistula closure
- Code 68770 closes a lacrimal fistula. Code 68760 is for closure of the lacrimal punctum, not a fistulous opening.
- 68700Canaliculus repair
- Code 68700 repairs the lacrimal canaliculus. It is not the code for occluding the punctum to retain tears.
68760 billing questions
How does this differ from 68761?
This code is for punctal closure by cautery, ligation, or another non-plug method. Code 68761 is for closure using a plug and is reported per punctum.
When is punctal closure used?
It is used to reduce tear drainage and retain tears, commonly in a patient with dry eye. The documentation should support the clinical reason for occlusion and identify the method performed.
How should bilateral treatment be reported?
When both sides are treated, report modifier 50. CMS pays a bilateral procedure at 150% under the rule for this code.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be billed?
CMS does not pay for 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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