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

Reports surgical creation of a drainage route from the lacrimal sac to the nasal cavity when a tube or stent is inserted to maintain patency.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Napa, CA, Medicare pays $827.34 for 68745 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$827.34Hospital or facility

Check a contract rate as a % of Medicare · 68745 nationwide

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

We’ll open 68745 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Napa, CA
  2. What 68745 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Napa, CA compares for 68745

Across 109 of 109 payment localities, the facility rate for 68745 runs from $643.02 in Arkansas to $887.58 in San Benito County, CA. Napa, CA pays $827.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

68745 in Napa, CA vs other payment areas
  1. Napa, CA · this page$827.34
  2. Bakersfield, CA · California$736.37−$90.97
  3. Chico, CA · California$733.83−$93.51
  4. El Centro, CA · California$733.96−$93.38
  5. Fresno, CA · California$733.83−$93.51
  6. Hanford, CA · California$733.83−$93.51
  7. Los Angeles, CA · California$776.02−$51.32

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

68745 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia—$733.83
Merced, CACalifornia—$733.83
Modesto, CACalifornia—$733.83
Oxnard, CACalifornia—$770.40
Redding, CACalifornia—$733.83
Rest of CaliforniaCalifornia—$733.83
Riverside, CACalifornia—$742.41
Sacramento, CACalifornia—$763.92

68745 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
68745 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 68745 in every payment locality

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.

How the rate is built · 68745

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.65

9.65 RVUs× 1.000 GPCI

Practice expense10.71

10.71 RVUs× 1.000 GPCI

Malpractice0.78

0.78 RVUs× 1.000 GPCI

Adjusted RVUs

21.1400

Conversion factor

$33.4009

Medicare rate

$706.10

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Napa, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,566

Code
68745
Physician work
9.65
Practice expense
10.71
Malpractice
0.78

GPCI2026.csv

17

Locality
Napa, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.508
Facility calculation for 68745 in Napa, CA
ComponentRVULocality factorAdjusted
Physician work9.65× 1.06310.2579
Practice expense10.71× 1.31814.1158
Malpractice0.78× 0.5080.3962
Total RVUs24.7700
Conversion factor× 33.4009

Facility rate, Napa, CA$827.34

Facility: (9.65 × 1.063 + 10.71 × 1.318 + 0.78 × 0.508) × $33.4009 = $827.34

Open 68745 in the RVU calculator

Payment rules and modifiers for 68745

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

CMS payment indicators · 68745

Tear duct bypass, with tube or stent

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68745

Tear duct bypass, with tube or stent

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68745 without 50 · national facility

$706.10

Tear duct bypass, with tube or stent

68745-50 · Bilateral: 150%

$1,059.15

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

How 68745 has changed in Napa, CA

68745 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$827.34RVU26D
2026-07-01Not available in this setting$827.34RVU26C
2026-04-01Not available in this setting$827.34RVU26B
2026-01-01Not available in this setting$827.34RVU26A
2025-10-01Not available in this setting$923.40RVU25D
2025-07-01Not available in this setting$923.40RVU25C
2025-04-01Not available in this setting$923.40RVU25B
2025-01-01Not available in this setting$923.40RVU25A
2024-10-01Not available in this setting$955.06RVU24D
2024-07-01Not available in this setting$955.06RVU24C
2024-04-01Not available in this setting$955.06RVU24B
2024-03-09Not available in this setting$955.06RVU24AR
2024-01-01Not available in this setting$939.48RVU24A
2023-10-01Not available in this setting$942.62RVU23D
2023-07-01Not available in this setting$942.62RVU23C
2023-04-01Not available in this setting$942.62RVU23B
2023-01-01Not available in this setting$942.62RVU23A
2022-10-01Not available in this setting$927.39RVU22D
2022-07-01Not available in this setting$927.39RVU22C
2022-04-01Not available in this setting$927.39RVU22B
2022-01-01Not available in this setting$927.39RVU22A
2021-10-01Not available in this setting$913.44RVU21D
2021-07-01Not available in this setting$913.44RVU21C
2021-04-01Not available in this setting$913.44RVU21B
2021-01-01Not available in this setting$913.44RVU21A
2020-10-01Not available in this setting$905.24RVU20D
2020-07-01Not available in this setting$905.24RVU20C
2020-04-01Not available in this setting$905.24RVU20B
2020-01-01Not available in this setting$905.24RVU20A
2019-10-01Not available in this setting$889.67RVU19D
2019-07-01Not available in this setting$889.67RVU19C
2019-04-01Not available in this setting$889.67RVU19B
2019-01-01Not available in this setting$889.67RVU19A
2018-10-01Not available in this setting$887.50RVU18D
2018-07-01Not available in this setting$887.50RVU18C
2018-04-01Not available in this setting$887.50RVU18B
2018-01-01Not available in this setting$887.50RVU18AR1
2017-10-01Not available in this setting$886.27RVU17D
2017-07-01Not available in this setting$886.27RVU17C
2017-04-01Not available in this setting$886.27RVU17B
2017-01-01Not available in this setting$886.27RVU17A
2016-10-01Not available in this settingRate data unavailableRVU16D
2016-07-01Not available in this settingRate data unavailableRVU16C
2016-04-01Not available in this settingRate data unavailableRVU16B
2016-01-01Not available in this settingRate data unavailableRVU16A
2015-10-01Not available in this settingRate data unavailableRVU15D
2015-07-01Not available in this settingRate data unavailableRVU15C
2015-04-01Not available in this settingRate data unavailableRVU15B
2015-01-01Not available in this settingRate data unavailableRVU15A
2014-10-01Not available in this settingRate data unavailableRVU14D
2014-07-01Not available in this settingRate data unavailableRVU14C
2014-04-01Not available in this settingRate data unavailableRVU14B
2014-01-01Not available in this settingRate data unavailableRVU14A
2013-10-01Not available in this settingRate data unavailableRVU13D
2013-07-01Not available in this settingRate data unavailableRVU13C
2013-04-01Not available in this settingRate data unavailableRVU13B
2013-01-01Not available in this settingRate data unavailableRVU13AR

Price 68745 for an earlier date of service

Where the Napa, CA rate applies

Napa, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Napa
  • American Canyon
  • Angwin
  • Calistoga
  • Deer Park
  • Moskowite Corner
  • Oakville
  • Rutherford

Browse all communities in California

68745 billing questions

How does this differ from 68720?

Both create a drainage route from the lacrimal sac to the nasal cavity. Report 68745 when a tube or stent is inserted; 68720 is the related procedure without that insertion.

Is tube or stent placement included?

Yes. Insertion of the tube or stent is part of the service represented by 68745.

How is bilateral surgery reported?

Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.

What documentation supports 68745?

The operative report should describe the lacrimal sac-to-nasal cavity bypass, the obstruction being treated, laterality, and insertion of the tube or stent.

How does the global period affect postoperative visits?

The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.

Can an assistant or co-surgeon be paid?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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

Show the CMS file lines behind this rate
RVUs for 68745PPRRVU2026_Oct_nonQPP.csv, line 7,566 (RVU26D)
Geographic factors for Napa, CAGPCI2026.csv, line 17 (RVU26D)

Open CMS sourceHow we calculate rates

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