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See a sample rate comparisonCPT 68745 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Surgery To Bypass Tear Duct, Surgery To Create A Drainage Passage Or Insert A Tube Between The Eye And The Nasal Passages. This Allows Tears To Drain When The Tear Duct Is Blocked.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 68745 |
| Medicaid Fee Schedule | View Medicaid rates for 68745 |
National average reimbursement for CPT 68745 by major payers:
$969.27
$991.42
$1,097.41
$1,274.50
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CPT 68745
5 of 25 sample ratesHigher to lower in this preview
Premier Adult And Childrens Surgery Center LLC
Summerlin Bend Surgery Center
$4,880.00Published rateCapital City Surgery Center, LLC
Capital City Surgery Center LLC
$3,215.00Published rateUpper Cumberland Physicians Surgery Center LLC
$1,452.00Published rateMidsouth Interventional Pain Institute, LLC
Midsouth Interventional Pain Institute LLC
$1,150.00Published rateG.I.Endoscopy Center
Giendoscopy Center
$390.00Published rate
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See a sample payer proposalCPT 68745 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68745 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 68745 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 68720-CPT | High | Bypass Blocked Tear Duct, Surgery To Create A Passage Between The Tear Sac And The Nasal Cavity To Allow Drainage Of Tears When There Is A Blockage Of The Tear Duct. |
| 68745-CPT | Moderate | Surgery To Bypass Tear Duct, Surgery To Create A Drainage Passage Or Insert A Tube Between The Eye And The Nasal Passages. This Allows Tears To Drain When The Tear Duct Is Blocked. |
| 68750-CPT | High | Surgery To Bypass Tear Duct, Surgery To Create A Drainage Passage Or Insert A Tube Between The Eye And The Nasal Passages. This Allows Tears To Drain When The Tear Duct Is Blocked. |
| 68761-CPT | Low | Clo Lacrimal Punct-Plug Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68745. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68745 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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