{
    "code": "68761",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/68761/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/68761/2018/C",
    "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 Q3 2018?",
        "text": "Medicare paid $152.28 for CPT 68761 in the office (non-facility) setting and $122.40 in a facility under the Q3 2018 Physician Fee Schedule, effective July 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2018, when it increased 1.8%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "C",
        "label": "Q3 2018",
        "effective": "July 1 – September 30, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 152.28,
        "facility": 122.4,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.41,
        "practice_expense_non_facility": 2.73,
        "practice_expense_facility": 1.9,
        "malpractice": 0.09
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q3 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18c1.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/C",
        "file": "PPRRVU18_JUL.csv",
        "row": 11411,
        "sha256": "514e3c115f8e62a35eb5f78fef7ed12ed7b60b22a5fe3f3f1bb5aadf119663c5"
    },
    "modified_at": "2026-08-04T03:08:27+00:00"
}