CPT code 68811: Tear duct probing2026 Medicare rate & RVUs in Oregon
Reports probing of an obstructed nasolacrimal duct under general anesthesia, commonly for persistent tear-drainage blockage in an infant.
CMS doesn’t publish an office rate for 68811 in Oregon.
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 9 sections
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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $123.39 |
| Rest Of Oregon | Unavailable | $115.86 |
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
Work1.70
1.70 RVUs× 1.000 GPCI
Practice expense1.67
1.67 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
3.5200
Conversion factor
$33.4009
Medicare rate
$117.57
Every GPCI starts 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
| 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 · 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.
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).
68811 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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