CPT code 68745: Tear duct bypass, with tube or stent2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 68745 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 68745 covers

An ophthalmologist, often an oculoplastic surgeon, performs this dacryocystorhinostomy to bypass an obstructed tear drainage pathway by connecting the lacrimal sac with the nasal cavity. A tube or stent is inserted as part of the operation to help keep the new passage open. The procedure is typically performed in an operating room for patients with persistent tearing related to nasolacrimal drainage obstruction.

Report this code when the surgeon creates the sac-to-nose drainage route and inserts a tube or stent; use the operative report to support the obstruction, surgical work, laterality, and device placement. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 68745 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 68745 rate is calculated

Each of 68745’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 68745

68745 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

68745 compared with similar codes

How to choose

68720Tear drainage surgeryNo tube or stent

Both procedures create a connection from the lacrimal sac to the nasal cavity. Choose 68745 when a tube or stent is inserted; choose 68720 when it is not.

68750Tear drainage bypassTube or stent placement

This procedure creates drainage from the lacrimal sac to the nose. Code 68750 creates a conjunctiva-to-nose route instead.

68815Duct probingWith tube or stent

Code 68815 describes probing and intubation of the nasolacrimal duct. Code 68745 creates a surgical bypass from the lacrimal sac to the nasal cavity.

Codes related to 68745

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates