$157.67–$182.78
Use 68810 for nasolacrimal duct probing without tube or stent placement. Use 68815 when a tube or stent is inserted during probing.
On this page
CMS RVU26D · Effective 2026-10-01
68815 Duct probing Medicare reimbursement rates in Virginia
Report nasolacrimal duct probing with tube or stent placement to treat tear-drainage obstruction, commonly in patients with persistent duct blockage. Compare 68815 office and facility rates across CMS payment localities in Virginia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 68815 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$366.30–$428.15
2 of 2 localities have a supported rate.
Facility setting
$189.33–$216.07
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmology procedure
About 68815: Nasolacrimal duct probing with stent
Report nasolacrimal duct probing with tube or stent placement to treat tear-drainage obstruction, commonly in patients with persistent duct blockage.
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.
CMS billing rules for 68815
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.63 · 24%
- Practice expense (office) RVU8.33 · 75%
- Malpractice RVU0.21 · 2%
9.8K
Medicare services in 2024 · #1473 by national volume
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.
68815 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
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.
$817.23–$970.88
Use 68816 when balloon catheter dilation is performed with probing. Use 68815 for probing with insertion of a tube or stent.
Compare 68815 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$428.15
Facility
$216.07
Virginia →
Office / nonfacility
$366.30
Facility
$189.33
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,57168801,,Dilate tear duct opening,A,,0.80,1.98,,1.30,,0.05,2.83,2.15,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57268810,,Probe nasolacrimal duct,A,,1.50,3.19,,1.74,,0.12,4.81,3.36,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57368811,,Probe nasolacrimal duct,A,,1.70,1.67,NA,1.67,,0.15,3.52,3.52,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57468815,,Probe nasolacrimal duct,A,,2.63,8.33,,2.94,,0.21,11.17,5.78,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57568816,,Probe nl duct w/balloon,A,,2.05,22.69,,1.80,,0.16,24.90,4.01,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57668840,,Explore/irrigate tear ducts,A,,1.27,2.66,,1.77,,0.09,4.02,3.13,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57768841,,Insj rx elut implt lac canal,A,,0.48,0.64,,0.30,,0.04,1.16,0.82,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00