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See a sample rate comparisonCPT 68720 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Bypass Blocked Tear Duct, Surgery To Create A Passage Between The Tear Sac And The Nasal Cavity To Allow Drainage Of Tears When There Is A Blockage Of The Tear Duct.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 68720 |
| Medicaid Fee Schedule | View Medicaid rates for 68720 |
National average reimbursement for CPT 68720 by major payers:
$1,001.11
$988.50
$1,082.25
$1,269.87
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CPT 68720
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Kingsland LLC, Memorial Hermann Surgery Center Kingsland
$7,838.00Published rateCenter For Health Ambulatory Surgery Center, LLC
Center For Health Ambulatory Surgery Center LLC
$3,085.00Published rateSouthwest Cardiovascular Interventional Center, LLC
Southwest Cardiovascular Interventional Center LLC
$1,800.00Published rateEye Surgery Center Of Chester County, LLC, Vision One Laser & Surgery Center
Eye Surgery Center Of Chester County, LLC
$1,142.00Published rateUpland Outpatient Surgery Center Lp, Ontario Advanced Surgery Center
Upland Outpatient Surgery Center Lp
$624.00Published rate
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See a sample payer proposalCPT 68720 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68720 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 68720 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 |
|---|---|---|
| 68720-CPT | High | Bypass Blocked Tear Duct, Surgery To Create A Passage Between The Tear Sac And The Nasal Cavity To Allow Drainage Of Tears When There Is A Blockage Of The Tear Duct. |
| 68745-CPT | Moderate | Surgery To Bypass Tear Duct, Surgery To Create A Drainage Passage Or Insert A Tube Between The Eye And The Nasal Passages. This Allows Tears To Drain When The Tear Duct Is Blocked. |
| 68750-CPT | High | Surgery To Bypass Tear Duct, Surgery To Create A Drainage Passage Or Insert A Tube Between The Eye And The Nasal Passages. This Allows Tears To Drain When The Tear Duct Is Blocked. |
| 68761-CPT | Low | Clo Lacrimal Punct-Plug Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68720 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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