$90.59
Use 68801 for punctal dilation without reconstruction. Use 68705 when the service reconstructs the punctum, whether or not dilation is also performed.
On this page
CMS RVU26D · Effective 2026-10-01
68705 Punctum revision Medicare reimbursement rates in Wisconsin
Reconstructs a narrowed or abnormal lacrimal punctum to improve tear drainage, with dilation included when performed as part of the repair. Compare 68705 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 68705 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
$248.14
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$136.47
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.
Ophthalmology procedure
About 68705: Lacrimal punctum reconstruction
Reconstructs a narrowed or abnormal lacrimal punctum to improve tear drainage, with dilation included when performed as part of the repair.
This procedure revises and reconstructs the lacrimal punctum, the small opening at the inner eyelid that drains tears. Ophthalmologists, including oculoplastic surgeons, may perform it for a narrowed or abnormal punctum associated with impaired tear drainage, such as persistent tearing. It may be performed in an office or an operating room, depending on the clinical circumstances and the extent of repair.
Report the code when the service involves reconstruction of the punctum; dilation performed as part of that service is included. Documentation should identify the affected side, the punctal abnormality, and the reconstruction performed. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. For bilateral services, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 68705
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.06 · 26%
- Practice expense (office) RVU5.55 · 71%
- Malpractice RVU0.17 · 2%
518
Medicare services in 2024 · #3535 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.
68705 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
68700 addresses repair of the lacrimal canaliculus; 68705 addresses reconstruction of the punctal opening.
$209.63
68760 closes the punctum to reduce tear drainage. 68705 reconstructs the opening, commonly to address impaired drainage.
$137.67
68761 closes the punctum with a plug. 68705 reconstructs the punctal opening rather than occluding it.
Compare 68705 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
$248.14
Facility
$136.47
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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 68705 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
7,564
- Code
- 68705
- Physician work
- 2.06
- Practice expense
- 5.55
- Malpractice
- 0.17
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.06 | × 1.000 | 2.0600 |
| Practice expense | 5.55 | × 0.958 | 5.3169 |
| Malpractice | 0.17 | × 0.308 | 0.0524 |
| Total RVUs | 7.4293 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$248.14
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1 |
| Practice expense | 5.55 | 0.958 |
| Malpractice | 0.17 | 0.308 |
(2.06 × 1 + 5.55 × 0.958 + 0.17 × 0.308) × $33.4009 = $248.14
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1 |
| Practice expense | 2.06 | 0.958 |
| Malpractice | 0.17 | 0.308 |
(2.06 × 1 + 2.06 × 0.958 + 0.17 × 0.308) × $33.4009 = $136.47
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.
68705 billing questions
When should 68705 be chosen instead of punctal dilation?
Use 68705 when the punctum is reconstructed, with or without dilation. Simple dilation without reconstruction is reported with 68801.
Can dilation be billed separately with 68705?
Dilation performed as part of the punctal reconstruction is included in 68705. The code covers reconstruction whether or not dilation is performed.
How is a bilateral punctal reconstruction reported?
For bilateral services, report modifier 50. CMS pays the bilateral procedure at 150%.
Are postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare 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 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.
7,56168540,,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
7,56768750,,Create tear duct drain,A,,9.85,11.75,NA,11.75,,0.82,22.42,22.42,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,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,,,,,,