No office rate
Both establish a nasal route for tear drainage, but 68745 uses the lacrimal sac and this code uses the conjunctival sac with a tube or stent.
On this page
CMS RVU26D · Effective 2026-10-01
68750 Tear drainage bypass Medicare reimbursement rates in Washington
A lacrimal surgeon creates a tear drainage pathway from the conjunctival sac to the nasal cavity and places a tube or stent. Compare 68750 office and facility rates across CMS payment localities in Washington.
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 68750 in Washington?
Washington 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
No supported rate
Facility setting
$767.38–$849.37
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.
Lacrimal surgery
About 68750: Conjunctival-to-nasal tear drainage bypass
A lacrimal surgeon creates a tear drainage pathway from the conjunctival sac to the nasal cavity and places a tube or stent.
This operation bypasses the usual tear drainage route by connecting the conjunctival sac to the nasal cavity with a tube or stent. Ophthalmologists specializing in oculoplastic or lacrimal surgery typically perform it for severe drainage obstruction when the normal canalicular pathway cannot provide adequate drainage. It is generally performed in an operating room, with the implant maintaining the new passage for tears.
Report this code when the surgeon creates the conjunctiva-to-nose pathway and places the tube or stent; that placement is part of the service. The operative report should identify the indication, side, new drainage route, and tube or stent placement. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 68750
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.85 · 44%
- Practice expense (office) RVU11.75 · 52%
- Malpractice RVU0.82 · 4%
539
Medicare services in 2024 · #3491 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.
68750 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
68720 creates a connection from the lacrimal sac to the nose. This code bypasses the usual drainage route from the conjunctival sac to the nose with a tube or stent.
No office rate
68700 reconstructs canaliculi; this code creates a bypass when the surgeon uses a conjunctiva-to-nose route with a tube or stent.
$269.22–$304.34
68705 addresses canalicular stenosis. Choose this code when the procedure instead creates the conjunctival bypass and places a tube or stent.
Compare 68750 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$767.38
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$849.37
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
68750 billing questions
When is this code preferred over a dacryocystorhinostomy?
Use this code when the surgeon creates a bypass from the conjunctival sac to the nose with a tube or stent. A dacryocystorhinostomy uses the lacrimal sac as the connection point.
Is placement of the tube or stent separately reported?
No. Tube or stent placement is included in this procedure.
How should bilateral surgery be reported?
CMS identifies the procedure as bilateral and pays modifier 50 at 150%. The operative documentation should establish that the procedure was performed on both sides.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care. It does not describe unrelated services.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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.
7,56468705,,Revise tear duct opening,A,,2.06,5.55,,2.06,,0.17,7.78,4.29,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56568720,,Create tear sac drain,A,,9.71,10.51,NA,10.51,,0.82,21.04,21.04,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56668745,,Create tear duct drain,A,,9.65,10.71,NA,10.71,,0.78,21.14,21.14,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56768750,,Create tear duct drain,A,,9.85,11.75,NA,11.75,,0.82,22.42,22.42,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56868760,,Close tear duct opening,A,,1.74,4.69,,1.94,,0.14,6.57,3.82,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,56968761,,Close tear duct opening,A,,1.37,2.85,,1.66,,0.07,4.29,3.10,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,57068770,,Close tear system fistula,A,,8.08,7.31,NA,7.31,,0.64,16.03,16.03,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00