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CPT code 69105: Ear canal biopsy, external auditory canal2026 Medicare rate & RVUs in Puerto Rico

Reports tissue sampling of a suspicious lesion in the external auditory canal when microscopic examination is needed to establish a diagnosis.

CMS RVU26DEffective Oct 1, 2026One payment locality1.7K Medicare services in 2024

In Puerto Rico, Medicare pays $145.14 for 69105 in the office and $57.68 when it’s performed in a hospital or facility.

$145.14Office (non-facility)
$57.68Hospital or facility
+0.8%vs the national office rate ($143.96)

Check a contract rate as a % of Medicare · 69105 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 69105 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 69105 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 69105 covers

An otolaryngologist typically performs this biopsy when tissue from a lesion in the external auditory canal is needed for diagnosis, such as evaluation of a growth or abnormal area in the ear canal. The canal extends inward from the ear opening toward the tympanic membrane; a biopsy of the visible outer ear instead is a different service. The procedure may be performed in an office or facility, depending on the lesion and clinical circumstances.

Choose this code when the service is tissue sampling for diagnosis, rather than definitive removal of the canal lesion. Document the canal site, the abnormal finding, the reason for sampling, and the specimen obtained. A separately performed pathology interpretation may be reported by the responsible pathologist. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. For bilateral reporting with modifier 50, CMS pays 150%. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

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.

How Puerto Rico compares for 69105

Across 109 of 109 payment localities, the office rate for 69105 runs from $126.30 in Arkansas to $195.05 in San Benito County, CA. Puerto Rico pays $145.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

69105 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$145.14
  2. Los Angeles, CA · California$164.46+$19.32
  3. Washington, DC area · District of Columbia$165.91+$20.77
  4. Miami, FL · Florida$154.19+$9.05
  5. Chicago, IL · Illinois$149.47+$4.33
  6. Manhattan, NY · New York$166.12+$20.98
  7. Alaska · Alaska$163.49+$18.35

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

69105 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$128.29$52.60
ArkansasArkansas$126.30$51.99
ArizonaArizona$139.94$56.11
Bakersfield, CACalifornia$153.85$59.04
Chico, CACalifornia$153.53$58.72
El Centro, CACalifornia$153.55$58.74
Fresno, CACalifornia$153.53$58.72
Hanford, CACalifornia$153.53$58.72

69105 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$126.30

$174.29

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
69105 office rate range by state
State / territoryOffice rate rangeLocalities
AK$163.491
AL$128.291
AR$126.301
AZ$139.941
CA$153.53–$195.0529
CO$150.691
CT$153.951
DC$165.911
DE$142.371
FL$140.85–$154.193
GA$132.51–$146.582
GU$157.831
HI$157.831
IA$132.171
ID$133.021
IL$136.23–$150.034
IN$133.851
KS$131.331
KY$131.151
LA$130.86–$137.822
MA$149.62–$166.532
MD$145.28–$165.913
ME$133.56–$141.592
MI$134.64–$142.542
MN$144.641
MO$128.33–$138.563
MS$127.351
MT$143.951
NC$135.091
ND$141.781
NE$133.011
NH$148.111
NJ$155.78–$163.962
NM$135.351
NV$143.461
NY$137.24–$170.155
OH$134.191
OK$131.091
OR$142.42–$155.962
PA$134.53–$149.782
PR$145.141
RI$147.801
SC$134.851
SD$141.521
TN$132.011
TX$133.57–$150.128
UT$136.831
VA$140.96–$165.912
VI$145.141
VT$141.021
WA$149.41–$170.222
WI$136.691
WV$130.801
WY$143.001

See 69105 in every payment locality

How the 69105 rate is calculated

Each of 69105’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 69105

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.83

0.83 RVUs× 1.000 GPCI

Practice expense3.37

3.37 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

4.3100

Conversion factor

$33.4009

Medicare rate

$143.96

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,585

Code
69105
Physician work
0.83
Practice expense
3.37
Malpractice
0.11

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 69105 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0000.8300
Practice expense3.37× 1.0113.4071
Malpractice0.11× 0.9850.1084
Total RVUs4.3454
Conversion factor× 33.4009

Office rate, Puerto Rico$145.14

Office: (0.83 × 1 + 3.37 × 1.011 + 0.11 × 0.985) × $33.4009 = $145.14

Facility: (0.83 × 1 + 0.78 × 1.011 + 0.11 × 0.985) × $33.4009 = $57.68

Open 69105 in the RVU calculator

Payment rules and modifiers for 69105

The CMS indicators that decide how 69105 is paid alongside other services.

CMS payment indicators · 69105

Ear canal biopsy, external auditory canal

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

69105 without 50 · national office

$143.96

Ear canal biopsy, external auditory canal

69105-50 · Bilateral: 150%

$215.94

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 69105

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 69105
CodeHow it relatesOffice range, Puerto Rico
Used instead
69100Ear biopsy, auricle, not ear canalUsed for biopsy of the external ear rather than tissue sampling within the auditory canal.$93.19
69140Ear canal excision, lesion removalCanal lesion excision is considered when the service removes rather than samples the lesion.No office rate
69145Ear canal excision, with or without tympanic membraneA canal lesion excision option when treatment involves removal rather than diagnostic biopsy.$407.97

How 69105 has changed in Puerto Rico

69105 · Office / nonfacility

$145.14

Effective 2026-10-01

The base rate is $6.68 higher than on 2025-10-01, moving from $138.46 to $145.14 (4.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $138.46changed to$145.14

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.85 changed to 0.83
    • Practice expense RVU 3.28 changed to 3.37
    • Malpractice RVU 0.13 changed to 0.11
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $145.52changed to$138.46

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.38 changed to 3.28
    • Malpractice RVU 0.12 changed to 0.13

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $143.14changed to$145.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $149.63changed to$143.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.42 changed to 3.38
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $148.76changed to$149.63

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $152.82changed to$148.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.43 changed to 3.42
    • Malpractice RVU 0.11 changed to 0.12
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $152.31changed to$152.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.36 changed to 3.43
    • Malpractice RVU 0.13 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $145.19changed to$152.31

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.04 changed to 3.36
    • Malpractice RVU 0.11 changed to 0.13
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $144.51changed to$145.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.02 changed to 3.04
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $142.18changed to$144.51

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.96 changed to 3.02

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $125.43changed to$142.18

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.00 changed to 2.96
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $108.68changed to$125.43

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.05 changed to 3.00
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $108.82changed to$108.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.04 changed to 3.05

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $108.28changed to$108.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $107.28changed to$108.28

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.06 changed to 3.04
    • Malpractice RVU 0.10 changed to 0.12
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $108.66changed to$107.28

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.42 changed to 3.06
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $108.66

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$145.14$57.68RVU26D
2026-07-01$145.14$57.68RVU26C
2026-04-01$145.14$57.68RVU26B
2026-01-01$145.14$57.68RVU26A
2025-10-01$138.46$63.55RVU25D
2025-07-01$138.46$63.55RVU25C
2025-04-01$138.46$63.55RVU25B
2025-01-01$138.46$63.55RVU25A
2024-10-01$145.52$64.06RVU24D
2024-07-01$145.52$64.06RVU24C
2024-04-01$145.52$64.06RVU24B
2024-03-09$145.52$64.06RVU24AR
2024-01-01$143.14$63.02RVU24A
2023-10-01$149.63$64.57RVU23D
2023-07-01$148.76$64.39RVU23C
2023-04-01$148.76$64.39RVU23B
2023-01-01$148.76$64.39RVU23A
2022-10-01$152.82$63.87RVU22D
2022-07-01$152.82$63.87RVU22C
2022-04-01$152.82$63.87RVU22B
2022-01-01$152.82$63.87RVU22A
2021-10-01$152.31$63.68RVU21D
2021-07-01$152.31$63.68RVU21C
2021-04-01$152.31$63.68RVU21B
2021-01-01$152.31$63.68RVU21A
2020-10-01$145.19$64.43RVU20D
2020-07-01$145.19$64.43RVU20C
2020-04-01$145.19$64.43RVU20B
2020-01-01$145.19$64.43RVU20A
2019-10-01$144.51$64.67RVU19D
2019-07-01$144.51$64.67RVU19C
2019-04-01$144.51$64.67RVU19B
2019-01-01$144.51$64.67RVU19A
2018-10-01$142.18$64.97RVU18D
2018-07-01$142.18$64.97RVU18C
2018-04-01$142.18$64.97RVU18B
2018-01-01$142.18$64.97RVU18AR1
2017-10-01$125.43$59.38RVU17D
2017-07-01$125.43$59.38RVU17C
2017-04-01$125.43$59.38RVU17B
2017-01-01$125.43$59.38RVU17A
2016-10-01$108.68$53.65RVU16D
2016-07-01$108.68$53.65RVU16C
2016-04-01$108.68$53.65RVU16B
2016-01-01$108.68$53.65RVU16A
2015-10-01$108.82$53.59RVU15D
2015-07-01$108.82$53.59RVU15C
2015-04-01$108.28$53.33RVU15B
2015-01-01$108.28$53.33RVU15A
2014-10-01$107.28$53.23RVU14D
2014-07-01$107.28$53.23RVU14C
2014-04-01$107.28$53.23RVU14B
2014-01-01$107.28$53.23RVU14A
2013-10-01$108.66$52.14RVU13D
2013-07-01$108.66$52.14RVU13C
2013-04-01$108.66$52.14RVU13B
2013-01-01$108.66$52.14RVU13AR

Price 69105 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

69105 billing questions

How is this different from 69100?

This code is for a biopsy in the external auditory canal. Code 69100 is for a biopsy of the external ear, such as the pinna.

When should an excision code be considered instead?

Use a canal lesion excision code when the service is removal rather than diagnostic tissue sampling. Codes 69140 and 69145 are the nearby canal-lesion excision choices.

Is the pathology examination included?

This code describes obtaining the tissue specimen. A separately performed pathology interpretation may be reported by the responsible pathologist.

How is bilateral biopsy paid?

For a bilateral procedure reported with modifier 50, CMS pays 150%.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others are paid at 50%. Same-day preoperative and postoperative care for this biopsy is included in its 0-day global period.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery are 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 69105PPRRVU2026_Oct_nonQPP.csv, line 7,585 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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