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See a sample rate comparisonCPT 68400 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Incis, Drainage Of Lacrimal Gland
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 68400 |
| Medicaid Fee Schedule | View Medicaid rates for 68400 |
National average reimbursement for CPT 68400 by major payers:
$343.63
$375.68
$404.09
$475.65
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CPT 68400
5 of 25 sample ratesHigher to lower in this preview
Ireland Grove Center For Surgery LLC.
Ireland Grove Center For Surgery, LLC
$1,500.00Published rateTampa Minimally Invasive Spine Surgery Center, LLC
Tampa Minimally Invasive Spine Surgery Center LLC
$1,188.00Published rateCenter For Spine Interventions Asc 2
$725.00Published rateNew Berlin Medical Services, LLC
New Berlin Medical Services LLC
$588.00Published rateDiane Hancock
Deaconess Hospital Inc
$234.13Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 68400 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68400 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 68400 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 68400-CPT | Moderate | Incis, Drainage Of Lacrimal Gland |
| 68420-CPT | Moderate | Ncision Drain Of Lacriml Sac (Dacryocystotomy Or Dacryocystostom, Incision Drainage Of Lacrimal Sac (Dacryocystotomy Or Dacryocystostom |
| 68440-CPT | Low | Snip Incision Of Lacrimal Punctum |
| 68530-CPT | Moderate | Remov.Fb/Dacryolith,Lacrimal Passag |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68400 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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