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CPT code 68815: Duct probing, with tube or stent2026 Medicare rate & RVUs in Washington, DC area

Report nasolacrimal duct probing with tube or stent placement to treat tear-drainage obstruction, commonly in patients with persistent duct blockage.

CMS RVU26DEffective Oct 1, 2026One payment locality9.8K Medicare services in 2024

In Washington, DC area, Medicare pays $428.15 for 68815 in the office and $216.07 when it’s performed in a hospital or facility.

$428.15Office (non-facility)
$216.07Hospital or facility
+14.8%vs the national office rate ($373.09)

Check a contract rate as a % of Medicare · 68815 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 68815 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 68815 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 68815 covers

An ophthalmologist probes the nasolacrimal duct to open an obstructed tear-drainage pathway and places a tube or stent to help maintain patency. The procedure is commonly used for persistent congenital nasolacrimal duct obstruction in children and may also be performed for acquired duct obstruction. It may include irrigation and is often performed in an operating room when a child requires anesthesia.

Choose this code when the probing includes placement of a tube or stent; probing without that placement is described by other codes in the family. Document the obstructed side, the probing, and tube or stent placement. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are 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 Washington, DC area compares for 68815

Across 109 of 109 payment localities, the office rate for 68815 runs from $330.46 in Arkansas to $502.47 in San Benito County, CA. Washington, DC area pays $428.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

68815 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$428.15
  2. Los Angeles, CA · California$425.25−$2.90
  3. Miami, FL · Florida$395.22−$32.93
  4. Chicago, IL · Illinois$384.18−$43.97
  5. Manhattan, NY · New York$427.89−$0.26
  6. Alaska · Alaska$431.95+$3.80
  7. Alabama · Alabama$335.27−$92.88

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

68815 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$330.46$175.81
ArizonaArizona$363.45$189.00
Bakersfield, CACalifornia$398.72$201.41
Chico, CACalifornia$398.04$200.72
El Centro, CACalifornia$398.07$200.76
Fresno, CACalifornia$398.04$200.72
Hanford, CACalifornia$398.04$200.72
Madera, CACalifornia$398.04$200.72

68815 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$330.46

$450.26

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
68815 office rate range by state
State / territoryOffice rate rangeLocalities
AK$431.951
AL$335.271
AR$330.461
AZ$363.451
CA$398.04–$502.4729
CO$390.411
CT$397.741
DC$428.151
DE$369.481
FL$364.37–$395.223
GA$344.39–$379.212
GU$408.251
HI$408.251
IA$345.211
ID$347.131
IL$352.83–$386.634
IN$349.171
KS$342.901
KY$341.611
LA$340.80–$357.632
MA$387.82–$429.892
MD$376.73–$428.153
ME$348.18–$368.002
MI$349.79–$368.162
MN$376.221
MO$334.51–$359.753
MS$332.581
MT$373.071
NC$351.911
ND$368.921
NE$347.301
NH$383.621
NJ$402.88–$423.622
NM$351.401
NV$372.191
NY$357.09–$437.315
OH$348.941
OK$341.751
OR$369.89–$403.582
PA$349.89–$387.432
PR$376.041
RI$383.181
SC$350.891
SD$368.431
TN$344.521
TX$347.55–$388.608
UT$355.681
VA$366.30–$428.152
VI$376.041
VT$366.841
WA$387.30–$439.352
WI$356.551
WV$339.661
WY$371.261

See 68815 in every payment locality

How the 68815 rate is calculated

Each of 68815’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 · 68815

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.63

2.63 RVUs× 1.000 GPCI

Practice expense8.33

8.33 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

11.1700

Conversion factor

$33.4009

Medicare rate

$373.09

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,574

Code
68815
Physician work
2.63
Practice expense
8.33
Malpractice
0.21

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 68815 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0542.7720
Practice expense8.33× 1.1789.8127
Malpractice0.21× 1.1130.2337
Total RVUs12.8185
Conversion factor× 33.4009

Office rate, Washington, DC area$428.15

Office: (2.63 × 1.054 + 8.33 × 1.178 + 0.21 × 1.113) × $33.4009 = $428.15

Facility: (2.63 × 1.054 + 2.94 × 1.178 + 0.21 × 1.113) × $33.4009 = $216.07

Open 68815 in the RVU calculator

Payment rules and modifiers for 68815

68815 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68815

Duct probing, with tube or stent

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 68815

Duct probing, with tube or stent

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

68815 without 50 · national office

$373.09

Duct probing, with tube or stent

68815-50 · Bilateral: 150%

$559.63

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

Codes related to 68815

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

Codes related to 68815
CodeHow it relatesOffice range, Washington, DC area
Same family
68810Tear duct probing, simple probingProbing without the tube or stent placement that distinguishes 68815.$182.78
68811Tear duct probing, general anesthesiaProbing requiring general anesthesia; 68815 is distinguished by tube or stent placement.No office rate
Used instead
68816Tear duct dilation, balloon catheterUses balloon catheter dilation rather than tube or stent placement.$970.88
68801Punctum dilation, punctal opening, with or without irrigationDilates the tear duct opening rather than probing and stenting the nasolacrimal duct.$107.93
68840Tear duct probing, lacrimal canaliculiAddresses the lacrimal canaliculi rather than the nasolacrimal duct.$152.72

How 68815 has changed in Washington, DC area

68815 · Office / nonfacility

$428.15

Effective 2026-10-01

The base rate is $16.75 higher than on 2025-10-01, moving from $411.40 to $428.15 (4.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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

  1. January 1, 2026

    RVU26A

    $411.40changed to$428.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.70 changed to 2.63
    • Practice expense RVU 8.07 changed to 8.33
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $432.49changed to$411.40

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.29 changed to 8.07
    • Malpractice RVU 0.22 changed to 0.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $425.43changed to$432.49

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $448.07changed to$425.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.32 changed to 8.29
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $463.35changed to$448.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.30 changed to 8.32
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $480.11changed to$463.35

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.61 changed to 8.30
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $470.17changed to$480.11

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.12 changed to 8.61
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $471.67changed to$470.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.30 changed to 8.12
    • Malpractice RVU 0.21 changed to 0.22
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $476.36changed to$471.67

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.42 changed to 8.30

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $470.07changed to$476.36

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.30 changed to 8.42
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $469.32changed to$470.07

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $531.05changed to$469.32

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 3.30 changed to 2.70
    • Practice expense RVU 9.11 changed to 8.30
    • Malpractice RVU 0.26 changed to 0.21

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $528.41changed to$531.05

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $537.55changed to$528.41

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.04 changed to 9.11
    • Malpractice RVU 0.56 changed to 0.26
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $548.06changed to$537.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.00 changed to 9.04
    • Malpractice RVU 0.59 changed to 0.56
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $548.06

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$428.15$216.07RVU26D
2026-07-01$428.15$216.07RVU26C
2026-04-01$428.15$216.07RVU26B
2026-01-01$428.15$216.07RVU26A
2025-10-01$411.40$243.29RVU25D
2025-07-01$411.40$243.29RVU25C
2025-04-01$411.40$243.29RVU25B
2025-01-01$411.40$243.29RVU25A
2024-10-01$432.49$250.36RVU24D
2024-07-01$432.49$250.36RVU24C
2024-04-01$432.49$250.36RVU24B
2024-03-09$432.49$250.36RVU24AR
2024-01-01$425.43$246.28RVU24A
2023-10-01$448.07$254.72RVU23D
2023-07-01$448.07$254.72RVU23C
2023-04-01$448.07$254.72RVU23B
2023-01-01$448.07$254.72RVU23A
2022-10-01$463.35$258.04RVU22D
2022-07-01$463.35$258.04RVU22C
2022-04-01$463.35$258.04RVU22B
2022-01-01$463.35$258.04RVU22A
2021-10-01$480.11$259.30RVU21D
2021-07-01$480.11$259.30RVU21C
2021-04-01$480.11$259.30RVU21B
2021-01-01$480.11$259.30RVU21A
2020-10-01$470.17$259.97RVU20D
2020-07-01$470.17$259.97RVU20C
2020-04-01$470.17$259.97RVU20B
2020-01-01$470.17$259.97RVU20A
2019-10-01$471.67$258.88RVU19D
2019-07-01$471.67$258.88RVU19C
2019-04-01$471.67$258.88RVU19B
2019-01-01$471.67$258.88RVU19A
2018-10-01$476.36$259.46RVU18D
2018-07-01$476.36$259.46RVU18C
2018-04-01$476.36$259.46RVU18B
2018-01-01$476.36$259.46RVU18AR1
2017-10-01$470.07$257.30RVU17D
2017-07-01$470.07$257.30RVU17C
2017-04-01$470.07$257.30RVU17B
2017-01-01$470.07$257.30RVU17A
2016-10-01$469.32$257.05RVU16D
2016-07-01$469.32$257.05RVU16C
2016-04-01$469.32$257.05RVU16B
2016-01-01$469.32$257.05RVU16A
2015-10-01$531.05$297.66RVU15D
2015-07-01$531.05$297.66RVU15C
2015-04-01$528.41$296.18RVU15B
2015-01-01$528.41$296.18RVU15A
2014-10-01$537.55$309.77RVU14D
2014-07-01$537.55$309.77RVU14C
2014-04-01$537.55$309.77RVU14B
2014-01-01$537.55$309.77RVU14A
2013-10-01$548.06$306.35RVU13D
2013-07-01$548.06$306.35RVU13C
2013-04-01$548.06$306.35RVU13B
2013-01-01$548.06$306.35RVU13AR

Price 68815 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

68815 billing questions

When should 68815 be chosen over 68810?

Use 68815 when nasolacrimal duct probing includes insertion of a tube or stent. Probing without tube or stent placement is reported with 68810.

Does anesthesia determine whether 68815 applies?

No. The distinguishing service is insertion of a tube or stent during probing, not the anesthesia used. The documentation should support the stent placement.

Can both sides be reported?

For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%. Document the procedure on each side.

Are postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure's payment.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for 68815. Co-surgeons and team surgery are 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 68815PPRRVU2026_Oct_nonQPP.csv, line 7,574 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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