{
    "code": "68761",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/68761/2015/D",
    "release_specific_url": "https://localishealth.com/cpt/68761/2015/D",
    "description": "Closure of a tear drainage opening with a small plug. Each eyelid has a pinhole at the inner corner, the punctum, that drains tears away into the nose; setting a silicone or collagen plug into it blocks that drain so the eye's own tears linger on the surface instead of running off. It is done at the slit lamp in a minute or two without anesthetic in most cases, and it is reported for each punctum treated. Separate codes cover permanently sealing the opening with heat or laser rather than a removable plug.",
    "answer": {
        "question": "How much did Medicare pay for CPT 68761 in Q4 2015?",
        "text": "Medicare paid $149.84 for CPT 68761 in the office (non-facility) setting and $121.10 in a facility under the Q4 2015 Physician Fee Schedule, effective October 2015. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.5% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2015,
        "quarter": "D",
        "label": "Q4 2015",
        "effective": "October 1 – December 31, 2015",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 149.84,
        "facility": 121.1,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.41,
        "practice_expense_non_facility": 2.67,
        "practice_expense_facility": 1.87,
        "malpractice": 0.09
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9335,
    "source": {
        "label": "Physician relative value file (Q4 2015)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu15d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2015/D",
        "file": "PPRRVU15_OCT05_V1001.csv",
        "row": 10842,
        "sha256": "302a55af716b26df5b42e80da7b2bd7cf5268007658df88133553f5e4e75523f"
    },
    "modified_at": "2026-08-04T03:06:14+00:00"
}