CPT 68815

Probe Nasolacrimal Duct W/Wo Irrg Insj Tube/Stnt

CPT 68815 pays $373.09 in a non-facility setting and $193.06 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $330.46 in Arkansas to $431.95 in Alaska, a 31% spread.

National non-facility rate

$373.09

Office and other outpatient settings

Facility rate
$193.06

Hospital and ASC settings

Highest state
$431.95

Alaska

Lowest state
$330.46

Arkansas · 31% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $373.09
CPT 68815 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $373.09, national facility $193.06.
StateRate compared visuallyNon-facilityFacility
Alaska
$431.95$240.21
District of Columbia
$428.15$216.07
California
$424.02$210.99
Washington
$413.33$208.09
New Jersey
$413.25$210.53
New York
$411.94$211.10
Massachusetts
$408.86$206.59
Hawaii
$408.25$203.56
Connecticut
$397.74$203.85
Colorado
$390.41$198.86
Oregon
$386.74$197.07
Maryland
$386.60$198.92
New Hampshire
$383.62$196.21
Rhode Island
$383.18$197.21
Florida
$380.66$200.02
Minnesota
$376.22$190.97
Puerto Rico
$376.04$194.03
Virgin Islands
$376.04$194.03
Montana
$373.07$193.04
Nevada
$372.19$191.98
Wyoming
$371.26$191.23
Illinois
$370.40$196.44
Delaware
$369.48$191.61
North Dakota
$368.92$188.89
Texas
$368.76$191.52
Pennsylvania
$368.66$192.32
South Dakota
$368.43$188.40
Vermont
$366.84$188.61
Virginia
$366.30$189.33
Arizona
$363.45$189.00
Georgia
$361.80$190.05
Michigan
$358.97$189.93
Maine
$358.09$186.07
Wisconsin
$356.55$184.08
Utah
$355.68$186.45
North Carolina
$351.91$183.95
New Mexico
$351.40$186.32
South Carolina
$350.89$184.54
Missouri
$350.07$184.86
Louisiana
$349.21$184.84
Indiana
$349.17$182.28
Ohio
$348.94$184.57
Nebraska
$347.30$181.13
Idaho
$347.13$181.50
Iowa
$345.21$180.48
Tennessee
$344.52$180.87
Kansas
$342.90$180.15
Oklahoma
$341.75$180.99
Kentucky
$341.61$181.56
West Virginia
$339.66$183.22
Alabama
$335.27$177.74
Mississippi
$332.58$177.58
Arkansas
$330.46$175.81

Billed by 2 specialties

Commercial rates for 68815

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates