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CPT 68761 Fee Schedule

Last Verified: December 2025

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 FactDetail
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 LevelLow

National average reimbursement for CPT 68761 by major payers:

bcbs

$179.91

uhc

$191.12

aetna

$205.20

cigna

$244.50

Preview provider-level rates for...
For billing codeCPT 68761
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 68761

United
68761$224.501316984198 - GEORGE YANG942317372 - (CA) SAN JOSE EYE INSTITUTECAOphthalmology Physician (207W00000X)
United
68761$250.501528177706 - JOHN REED942442567 - (CA) VITREO-RETINAL MEDICAL GROUP, INC.CARetina Specialist (Ophthalmology) Physician (207WX0107X)
United
68761$109.191023270345 - EMILY HUYNH270455537 - (CA) HEIDI Q.T. PHAM-MURPHY, O.D., INC. VISIONS OPTOMETRY EYECARE & EYEWEARCAOptometrist (152W00000X)
United
68761$129.271033966775 - EMILY NICKLES752980191 - (CA) CALIFORNIA EYE SPECIALISTS MEDCAOptometrist (152W00000X)
United
68761$128.851245504851 - MARZENA GILBERT274070788 - (CA) VENTURA OPTOMETRIC VISION CARE, INC.CAOptometrist (152W00000X)
United
68761$130.191174891915 - LINDY HOANG261881108 - (CA) DANIEL C. KLINE M.D., INC.CAOptometrist (152W00000X)
United
68761$112.581215331269 - MITCH BOVY832617711 - (CA) SPECTACLE OPTOMETRY INCCAOptometrist (152W00000X)
United
68761$115.431073577508 - PAUL YANG260037948 - (CA) ALVIN ARELLANO, O.D., INC.CAOptometrist (152W00000X)
United
68761$151.191659338952 - SHIRIN BAREZ942393405 - (CA) OPTIMA OPHTHALMIC MEDICAL ASSOCIATES, INC.CAOphthalmology Physician (207W00000X)
United
68761$134.521598898249 - DR. ZHUBLAWAR OPTOMETRIC CORPORATION, THE OPTOMETRY CENTER943363573 - (CA) DR ZHUBLAWAR OPTOMETRIC CORPORATIONCAOptometrist (152W00000X)
United
68761$206.691659338952 - SHIRIN BAREZ943043556 - (CA) EAST BAY PERINATAL MEDICAL ASSOCIATESCAOphthalmology Physician (207W00000X)
United
68761$135.551215907076 - EILEEN CHENG203690837 - (CA) LOOKING GLASS OPTOMETRY, INC.CAOptometrist (152W00000X)
United
68761$121.801366422917 - ROBERT SORENSON330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATIONCAOphthalmology Physician (207W00000X)
United
68761$163.801740508506 - AIMEE EDELL710888792 - (CA) EAST BAY EYE CENTERS MEDICAL CORPCAOphthalmology Physician (207W00000X)
United
68761$134.391487774949 - ANYA TRUMLER-SEBRING770019313 - (CA) MIRAMAR EYE SPECIALISTS MEDICAL GROUP, INC.NCOphthalmology Physician (207W00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
68760-CPTModerateClo Lacrimal Punct-Thermocaut/Laser
68761-CPTLowClo Lacrimal Punct-Plug Each
68801-CPTLowDilation Of Lacrimal Punctum, With Or Without Irrigation
68810-CPTModerateProbing 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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