$248.14
Choose 68700 for repair of the canalicular channel, commonly after trauma. Choose 68705 when the operative target is an everted punctum.
On this page
CMS RVU26D · Effective 2026-10-01
68700 Canaliculus repair Medicare reimbursement rates in Wisconsin
Repair of a damaged tear drainage canaliculus, commonly after trauma near the inner eyelid, to restore continuity of the drainage channel. Compare 68700 office and facility rates across CMS payment localities in Wisconsin.
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 68700 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$491.99
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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.
Ophthalmic surgery
About 68700: Lacrimal canaliculus repair
Repair of a damaged tear drainage canaliculus, commonly after trauma near the inner eyelid, to restore continuity of the drainage channel.
This procedure repairs a canaliculus, the small channel that carries tears from an eyelid opening toward the tear sac. Ophthalmologists, often oculoplastic surgeons, commonly perform it for a canalicular laceration near the inner corner of the eye, such as one caused by facial trauma. The repair may use fine sutures and a temporary stent to align and support the channel while it heals.
Report the service when the operative work repairs the canaliculus itself, not merely the eyelid opening or the tear sac. Documentation should identify the affected canaliculus, the injury or defect, laterality, and the repair performed. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 68700
- 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 RVU7.67 · 50%
- Practice expense (office) RVU7.17 · 46%
- Malpractice RVU0.62 · 4%
3.1K
Medicare services in 2024 · #2145 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.
68700 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
68700 repairs a damaged canaliculus. 68720 creates a drainage connection from the tear sac to the nose.
No office rate
68700 repairs the existing canalicular channel; 68745 establishes a different route for tears through a conjunctival connection.
Compare 68700 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
Unavailable
Facility
$491.99
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 68700 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
7,563
- Code
- 68700
- Physician work
- 7.67
- Practice expense
- 7.17
- Malpractice
- 0.62
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.67 | × 1.000 | 7.6700 |
| Practice expense | 7.17 | × 0.958 | 6.8689 |
| Malpractice | 0.62 | × 0.308 | 0.1910 |
| Total RVUs | 14.7298 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$491.99
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.67 | 1 |
| Practice expense | 7.17 | 0.958 |
| Malpractice | 0.62 | 0.308 |
(7.67 × 1 + 7.17 × 0.958 + 0.62 × 0.308) × $33.4009 = $491.99
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
68700 billing questions
When should 68700 be chosen over 68705?
Use 68700 for repair of the tear-drainage canaliculus itself, such as after a laceration. Code 68705 addresses correction of an everted punctum rather than repair of a canalicular injury.
Is repair of an associated eyelid wound included?
The canalicular repair describes work on the tear channel. Document any separate eyelid repair distinctly so the services can be evaluated based on the work performed.
What documentation supports 68700?
Record the canaliculus involved, laterality, cause and extent of the defect, and the repair technique. Include whether a stent was used when applicable.
How is bilateral canalicular repair reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. Document the repair on each side.
Can an assistant, co-surgeon, or surgical team be billed?
CMS restricts assistant-at-surgery payment for this code and does not permit co-surgeons or team surgery.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
7,56068530,,Clearance of tear duct,A,,3.61,9.09,,2.48,,0.28,12.98,6.37,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56168540,,Remove tear gland lesion,A,,11.88,12.54,NA,12.54,,0.95,25.37,25.37,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56268550,,Remove tear gland lesion,A,,14.78,15.57,NA,15.57,,1.19,31.54,31.54,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56368700,,Repair tear ducts,A,,7.67,7.17,NA,7.17,,0.62,15.46,15.46,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56468705,,Revise tear duct opening,A,,2.06,5.55,,2.06,,0.17,7.78,4.29,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56568720,,Create tear sac drain,A,,9.71,10.51,NA,10.51,,0.82,21.04,21.04,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56668745,,Create tear duct drain,A,,9.65,10.71,NA,10.71,,0.78,21.14,21.14,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,