CPT code 68801 represents dilation of the lacrimal punctum, a minor ophthalmic procedure used to treat punctal stenosis, obstruction, or traumatic narrowing that causes epiphora. Nationally, this code is relevant across outpatient ophthalmology and optometry settings where tear drainage dysfunction impacts patient comfort and visual surface health. Payers commonly covering services in this area include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

This publication provides a concise national overview of CPT code 68801, explaining the clinical context, typical sites of service, and common payment considerations. Readers will find clinical context about indications for punctal dilation and what the procedure entails, a summary of payer coverage patterns and common modifiers in use, and guidance on where to look for coding and billing guidance. The summary highlights what to expect in terms of service classification (minor ophthalmic surgical/office-based procedure) and typical outpatient settings. Data not available in the input is noted where applicable. The goal is to equip billing managers, clinicians, and policy analysts with clear, actionable information about the purpose and billing classification of CPT code 68801 without making clinical recommendations.