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See a sample rate comparisonCPT 68761 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.
Clo Lacrimal Punct-Plug Each
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None E2 - Lower left, eyelid E4 - Lower right, eyelid |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 68761 |
| Medicaid Fee Schedule | View Medicaid rates for 68761 |
National average reimbursement for CPT 68761 by major payers:
$179.91
$191.12
$205.20
$197.00
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CPT 68761
5 of 25 sample ratesHigher to lower in this preview
Gavin Bahadur
Regents University Of California
$693.95Published rateJames Song
$155.03Published rateDaniel Christensen
Elite Eyecare Medical
$134.52Published rateZamora Optometry Inc, Montebello Optometry
Zamora Optometry Inc
$113.40Published rateAnn Nguyen
Winnick Optometry PC
$109.19Published rate
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See a sample payer proposalCPT 68761 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68761 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 68761 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 |
|---|---|---|
| 68760-CPT | Moderate | Surgery To Close Off Tear Duct, Surgery To Close Off One Or More Tear Ducts To Relieve Or Prevent Excessive Tearing. The Duct May Be Closed With Heat A Laser Or Sutures. |
| 68761-CPT | Low | Clo Lacrimal Punct-Plug Each |
| 68801-CPT | Low | Dilation Of Lacrimal Punctum, With Or Without Irrigation |
| 68810-CPT | Moderate | Probing Of Nasolacrimal Duct, With Or Without Irrigation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68761. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68761 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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