$159.62
Both report nasolacrimal duct probing, but 68811 is for cases requiring general anesthesia; 68810 is used when it is not required.
On this page
CMS RVU26D · Effective 2026-10-01
68811 Tear duct probing Medicare reimbursement rates in Wyoming
Reports probing of an obstructed nasolacrimal duct under general anesthesia, commonly for persistent tear-drainage blockage in an infant. Compare 68811 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 68811 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
$116.27
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.
Ophthalmology procedure
About 68811: Nasolacrimal duct probing under anesthesia
Reports probing of an obstructed nasolacrimal duct under general anesthesia, commonly for persistent tear-drainage blockage in an infant.
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.
CMS billing rules for 68811
- 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 RVU1.70 · 48%
- Practice expense (office) RVU1.67 · 47%
- Malpractice RVU0.15 · 4%
531
Medicare services in 2024 · #3502 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.
68811 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$371.26
Use 68815 when probing includes insertion of a tube or stent; 68811 describes probing without that added device placement.
$830.29
Use 68816 for balloon catheter dilation of the nasolacrimal duct rather than probing under general anesthesia alone.
$94.09
68801 dilates the tear-drainage opening; 68811 probes farther along the nasolacrimal duct under general anesthesia.
Compare 68811 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
$116.27
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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 68811 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,573
- Code
- 68811
- Physician work
- 1.70
- Practice expense
- 1.67
- Malpractice
- 0.15
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.70 | × 1.000 | 1.7000 |
| Practice expense | 1.67 | × 1.000 | 1.6700 |
| Malpractice | 0.15 | × 0.740 | 0.1110 |
| Total RVUs | 3.4810 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$116.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.7 | 1 |
| Practice expense | 1.67 | 1 |
| Malpractice | 0.15 | 0.74 |
(1.7 × 1 + 1.67 × 1 + 0.15 × 0.74) × $33.4009 = $116.27
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.
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 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.
7,57068770,,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
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
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.,,,,,,