CPT 68420 Surgery - Eye
I&d lacrimal sac Cost
Body System: Eye
Medicare Facility Rate
$141
CMS PFS CY2026
Medicare Non-Facility Rate
$331
Office/clinic setting
Hospital Outpatient
$2
OPPS rate
Surgery Center (ASC)
$250
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
2.29
Work RVU
1.75
Facility PE RVU
0.18
Malpractice RVU
9.90
Total RVU
Frequently Asked Questions
How much does I&d lacrimal sac cost?
The Medicare facility rate is $141. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $2. Ambulatory surgery center rate: $250.
How much does I&d lacrimal sac cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $141.