CPT code 68815: Duct probing, with tube or stent2026 Medicare rate & RVUs in Michigan
Report nasolacrimal duct probing with tube or stent placement to treat tear-drainage obstruction, commonly in patients with persistent duct blockage.
Medicare pays $349.79–$368.16 for 68815 in the office in Michigan, from Rest of Michigan to Detroit, MI. Which amount applies depends on the service address.
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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On this page 9 sections
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.
Where 68815 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $368.16 | $194.43 |
| Rest of Michigan | $349.79 | $185.42 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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).
68815 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 68810Tear duct probingSimple probing
- Use 68810 for nasolacrimal duct probing without tube or stent placement. Use 68815 when a tube or stent is inserted during probing.
- 68811Tear duct probingGeneral anesthesia
- Use 68811 for probing requiring general anesthesia without the defining tube or stent placement. Use 68815 when probing includes insertion of a tube or stent.
- 68816Tear duct dilationBalloon catheter
- Use 68816 when balloon catheter dilation is performed with probing. Use 68815 for probing with insertion of a tube or stent.
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
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