Price Checker / CPT 68801

How much does Dilate Tear Duct Opening cost?

CPT 68801 · Based on 2026 Medicare rates and hospital-published pricing

Severe overcharge

The average hospital charge is around 42x the fair price — among the most extreme markups. Dispute this.

Fair price

$460–$540

What this should cost

With insurance

~$2,250

Typical out-of-pocket

Overcharged if over

$680

Push back above this

The average hospital charge of $20,852 is $20,352 over the fair price (about 42x the fair rate).

What hospitals charge for Dilate Tear Duct Opening

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
Dominican Hospital

SANTA CRUZ, CA

28711%
Arroyo Grande Community Hospital

, CA

15211%

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About Dilate Tear Duct Opening

CPT code 68801 refers to dilate tear duct opening (billing description: "Dilate tear duct opening"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $72 in a facility (hospital or surgery center) and $95 in a doctor's office.

The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.

What to do if you were overcharged

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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