CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 68811 RVU and Medicare Payment (2026)
Probe nasolacrimal duct — 1.7 work RVU, about $117.57 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.7
- PE RVU (non-facility)
- 1.67
- PE RVU (facility)
- 1.67
- MP RVU
- 0.15
- Office payment
- $117.57
- Facility payment
- $117.57
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 68811 in a non-facility setting with national GPCI: (1.7 + 1.67 + 0.15) × $33.4009 ≈ $117.57. The same code in a facility setting pays about $117.57 because facility PE RVU (1.67) replaces office PE RVU.
What changes by locality
GPCI moves 68811 non-facility payment from $107.28 to $147.34 across CMS localities — from Arkansas to Alaska. Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 68811?
1.7. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 68811 in 2026?
About $117.57 non-facility ($117.57 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (1.7) and malpractice RVU stay fixed; only practice expense changes (1.67 office vs 1.67 facility). That is the entire office-vs-facility payment gap.