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Billing code 68811: Tear duct probingMedicare rate & RVUs

Reports probing of an obstructed nasolacrimal duct under general anesthesia, commonly for persistent tear-drainage blockage in an infant.

CMS RVU26DEffective Oct 1, 2026109 payment localities531 Medicare services in 2024

Medicare pays $117.57 for 68811 nationally in a facility.

Medicare rate · 68811

Tear duct probing

Swap in your local Medicare rate.

Work RVUs
1.7
Total RVUs
3.52
Global days
010

National rate · 2026

$117.57

Facility setting, before claim adjustments.

See every locality for 68811 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 68811 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 68811 covers

An ophthalmologist passes a probe through the tear-drainage opening and canaliculus to open an obstructed nasolacrimal duct; irrigation may also be performed. A common setting is the operating room, where an infant with persistent congenital nasolacrimal duct obstruction undergoes probing under general anesthesia after conservative care has not resolved symptoms.

Choose this code when the duct probing requires general anesthesia; distinguish it from probing without that requirement and from procedures that add a tube or balloon dilation. The operative note should identify the treated side, obstruction and probing performed, use of irrigation, and general anesthesia. Related postoperative visits during the 10-day global period are included. For bilateral work, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery 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 68811 pays more and less

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

109 of 109 payment localities

68811 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$108.42
Alaska*Unavailable$147.34
ArizonaUnavailable$115.12
ArkansasUnavailable$107.28
AtlantaUnavailable$119.64
AustinUnavailable$120.35
BakersfieldUnavailable$122.05
Baltimore/Surr. CntysUnavailable$123.74
BeaumontUnavailable$112.20
BrazoriaUnavailable$116.42

68811 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
68811 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

How the 68811 rate is calculated

Each of 68811’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 · 68811

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.70Practice expense 1.67Malpractice 0.15

3.5200 adjusted RVUs×$33.4009 conversion factor=$117.57

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 68811

68811 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 68811

Tear duct probing

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 · 68811

Tear duct probing

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

68811 without 50 · national facility

$117.57

Tear duct probing

68811-50 · Bilateral: 150%

$176.36

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

68811 compared with similar codes

Compare codes

68811 vs 68810 vs 68815 vs 68816 vs 68801: national Medicare rates

Swap in your local Medicare rate.

  • 68811
    Tear duct probing · 1.7 wRVU
    —
  • 68810
    Tear duct probing · 1.5 wRVU
    $160.66
  • 68815
    Duct probing · 2.63 wRVU
    $373.09
  • 68816
    Tear duct dilation · 2.05 wRVU
    $831.68
  • 68801
    Punctum dilation · 0.8 wRVU
    $94.52

How to choose

68810Tear duct probing
Both report nasolacrimal duct probing, but 68811 is for cases requiring general anesthesia; 68810 is used when it is not required.
68815Duct probing
Use 68815 when probing includes insertion of a tube or stent; 68811 describes probing without that added device placement.
68816Tear duct dilation
Use 68816 for balloon catheter dilation of the nasolacrimal duct rather than probing under general anesthesia alone.
68801Punctum dilation
68801 dilates the tear-drainage opening; 68811 probes farther along the nasolacrimal duct under general anesthesia.

Codes related to 68811

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

Codes related to 68811
CodeHow it relatesNational office range
Same family
68810Tear duct probingNasolacrimal duct probing when general anesthesia is not required.$143.69–$211.40
Used instead
68815Duct probingProbing that includes placement of a lacrimal tube or stent.$330.46–$502.47
68816Tear duct dilationUses balloon catheter dilation for nasolacrimal duct obstruction.$722.23–$1,171.71

68811 billing questions

When should 68811 be chosen instead of 68810?

Use 68811 when nasolacrimal duct probing requires general anesthesia. 68810 is the related probing code when general anesthesia is not required.

Does 68811 include irrigation?

Yes. Irrigation may be performed as part of the duct probing and is included in this service.

How is bilateral probing reported?

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

What documentation supports 68811?

Document the obstruction, side treated, probing performed, whether irrigation was used, and that the procedure required general anesthesia.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Are postoperative visits included?

Related postoperative visits during the 10-day global period are included.

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 68811PPRRVU2026_Oct_nonQPP.csv, line 7,573 (RVU26D)

Open CMS sourceHow we calculate rates

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