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See a sample rate comparisonCPT 68770 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.
Closure Of Lacrimal Fistula
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 68770 |
| Medicaid Fee Schedule | View Medicaid rates for 68770 |
National average reimbursement for CPT 68770 by major payers:
$780.26
$793.67
$857.68
$999.53
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CPT 68770
5 of 25 sample ratesHigher to lower in this preview
Greater Dayton Surgery Center LLC
Greater Dayton Surgery Center
$4,639.00Published rateGrand Rapids Surgical Suites LLC
Grand Rapids Surgical Suites, PLLC
$934.00Published rateElkhart Day Surgery, LLC, Insight Surgery Center
Elkhart Day Surgery LLC
$539.00Published rateLubbock Interventional Nephrology Associates PA, Lubbock Vascular Access
Lubbock Interventional Nephrology Associates PA
$410.00Published rateOutpatient Surgical Care Ltd
$270.00Published rate
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See a sample payer proposalCPT 68770 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68770 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 68770 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 |
|---|---|---|
| 68770-CPT | Moderate | Closure Of Lacrimal Fistula |
| 68801-CPT | Low | Dilation Of Lacrimal Punctum, With Or Without Irrigation |
| 68810-CPT | Moderate | Probing Of Nasolacrimal Duct, With Or Without Irrigation |
| 68815-CPT | Moderate | Probing Of Nasolacrimal Duct W//W/O Irrigation; W/ Inserti, Probing Of Nasolacrimal Duct With Or Without Irrigation; With Inserti |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68770. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68770 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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