Billing code 68841: Lacrimal implantMedicare rate & RVUs in Washington
Reports placement of a drug-eluting implant in a lacrimal canaliculus, commonly to deliver sustained medication after ophthalmic surgery.
Medicare pays $39.77–$44.15 for 68841 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 68841 covers
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.
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 68841 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $39.77 | $27.81 |
| Seattle (King Cnty) | $44.15 | $30.22 |
How the 68841 rate is calculated
Each of 68841’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 · 68841
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.48Practice expense 0.64Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 68841
The CMS indicators that decide how 68841 is paid alongside other services.
CMS payment indicators · 68841
Lacrimal implant
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
68841 without 50 · national office
$38.75
Lacrimal implant
68841-50 · Bilateral: 150%
$58.13
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).
68841 compared with similar codes
Compare codes
68841 vs 68801 vs 68810 vs 68815 vs 68840: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 68801Punctum dilation
- 68801 is for dilation of the lacrimal punctum. With 68841, dilation needed to place the drug-eluting implant is included.
- 68810Tear duct probing
- 68810 probes the nasolacrimal duct; it addresses tear-drainage patency rather than medication implant placement.
- 68815Duct probing
- 68815 probes the nasolacrimal duct, with or without irrigation. It is a duct procedure, not placement of a drug-eluting canalicular implant.
- 68840Tear duct probing
- 68840 explores or irrigates the lacrimal canaliculi. Choose it for canalicular evaluation or irrigation, not implant delivery.
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 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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