CPT code 68745: Tear duct bypass, with tube or stent2026 Medicare rate & RVUs in Missouri
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 doesn’t publish an office rate for 68745 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $683.67 |
| Metropolitan St. Louis, MO | Unavailable | $688.98 |
| Rest of Missouri | Unavailable | $656.05 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share 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.
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).
68745 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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