68816 Probe nl duct with balloon
Also known as: balloon dilation duct, balloon dacryoplasty
Probing of nasolacrimal duct with balloon catheter dilation to open obstruction and enlarge ductal system.
In Plain Language
opening tear duct with balloon; dilating tear duct with balloon
Clinical Context
Used for nasolacrimal duct obstruction with stricture. Common indications include strictured obstruction, fibrotic obstruction, or failed simple probing.
RVU Breakdown
| Work RVU | 2.05 |
| Total RVU | 2.05 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 10-day global period — follow-up visits within 10 days of the procedure are included in the reimbursement. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 2.05, this code ranks in the 14th percentile among Surgery codes — 3.9x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 68816?
CPT 68816 (Probe nl duct with balloon) is a Surgery code. Probing of nasolacrimal duct with balloon catheter dilation to open obstruction and enlarge ductal system.
What is the wRVU value for CPT 68816?
The work RVU for CPT 68816 is 2.05. This code is primarily used by Ophthalmology. It has a 10-day global period.
When is CPT 68816 used?
Used for nasolacrimal duct obstruction with stricture. Common indications include strictured obstruction, fibrotic obstruction, or failed simple probing.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.