No office rate
Both procedures create a connection from the lacrimal sac to the nasal cavity. Choose 68745 when a tube or stent is inserted; choose 68720 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
68745 Tear duct bypass Medicare reimbursement rates in Wyoming
Reports surgical creation of a drainage route from the lacrimal sac to the nasal cavity when a tube or stent is inserted to maintain patency. Compare 68745 office and facility rates across CMS payment localities in Wyoming.
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 68745 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$699.32
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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.
Ophthalmic surgery
About 68745: Dacryocystorhinostomy with stent
Reports surgical creation of a drainage route from the lacrimal sac to the nasal cavity when a tube or stent is inserted to maintain patency.
An ophthalmologist, often an oculoplastic surgeon, performs this dacryocystorhinostomy to bypass an obstructed tear drainage pathway by connecting the lacrimal sac with the nasal cavity. A tube or stent is inserted as part of the operation to help keep the new passage open. The procedure is typically performed in an operating room for patients with persistent tearing related to nasolacrimal drainage obstruction.
Report this code when the surgeon creates the sac-to-nose drainage route and inserts a tube or stent; use the operative report to support the obstruction, surgical work, laterality, and device placement. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For bilateral surgery reported with modifier 50, CMS pays 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 68745
- 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 RVU9.65 · 46%
- Practice expense (office) RVU10.71 · 51%
- Malpractice RVU0.78 · 4%
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.
68745 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
This procedure creates drainage from the lacrimal sac to the nose. Code 68750 creates a conjunctiva-to-nose route instead.
$371.26
Code 68815 describes probing and intubation of the nasolacrimal duct. Code 68745 creates a surgical bypass from the lacrimal sac to the nasal cavity.
Compare 68745 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$699.32
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 68745 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,566
- Code
- 68745
- Physician work
- 9.65
- Practice expense
- 10.71
- Malpractice
- 0.78
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.65 | × 1.000 | 9.6500 |
| Practice expense | 10.71 | × 1.000 | 10.7100 |
| Malpractice | 0.78 | × 0.740 | 0.5772 |
| Total RVUs | 20.9372 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$699.32
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.65 | 1 |
| Practice expense | 10.71 | 1 |
| Malpractice | 0.78 | 0.74 |
(9.65 × 1 + 10.71 × 1 + 0.78 × 0.74) × $33.4009 = $699.32
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
68745 billing questions
How does this differ from 68720?
Both create a drainage route from the lacrimal sac to the nasal cavity. Report 68745 when a tube or stent is inserted; 68720 is the related procedure without that insertion.
Is tube or stent placement included?
Yes. Insertion of the tube or stent is part of the service represented by 68745.
How is bilateral surgery reported?
Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.
What documentation supports 68745?
The operative report should describe the lacrimal sac-to-nasal cavity bypass, the obstruction being treated, laterality, and insertion of the tube or stent.
How does the global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. 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.
7,56368700,,Repair tear ducts,A,,7.67,7.17,NA,7.17,,0.62,15.46,15.46,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,