CPT code 69145: Ear canal excision, with or without tympanic membrane2026 Medicare rate & RVUs in New Mexico
Reports operative excision of a lesion in the external auditory canal, including cases where the tympanic membrane is involved or removed.
In New Mexico, Medicare pays $382.21 for 69145 in the office and $228.45 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 69145 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 69145 covers
This service removes a lesion from the external auditory canal rather than sampling it solely for diagnosis. An otolaryngologist typically performs the excision in an operating room or, when clinically appropriate, another procedural setting. The operative record should identify the lesion’s canal location and describe its extent, the tissues removed, and any tympanic membrane involvement. A lesion such as a canal mass may require excision when removal, rather than biopsy alone, is the planned treatment.
Select this code for the documented canal lesion excision; use a simple-excision or extensive-excision sibling when the operative service matches that distinct level. The record should support the scope of surgery and whether the tympanic membrane was involved. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. 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 New Mexico compares for 69145
Across 109 of 109 payment localities, the office rate for 69145 runs from $355.64 in Arkansas to $542.78 in San Benito County, CA. New Mexico pays $382.21. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$382.21
- Los Angeles, CA · California$459.67+$77.46
- Washington, DC area · District of Columbia$465.14+$82.93
- Miami, FL · Florida$437.20+$54.99
- Chicago, IL · Illinois$423.82+$41.61
- Manhattan, NY · New York$467.31+$85.10
- Alaska · Alaska$462.65+$80.44
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $361.17 | $214.46 |
| ArkansasArkansas | $355.64 | $211.61 |
| ArizonaArizona | $393.52 | $231.05 |
| Bakersfield, CACalifornia | $430.57 | $246.80 |
| Chico, CACalifornia | $429.45 | $245.68 |
| El Centro, CACalifornia | $429.51 | $245.74 |
| Fresno, CACalifornia | $429.45 | $245.68 |
| Hanford, CACalifornia | $429.45 | $245.68 |
| Madera, CACalifornia | $429.45 | $245.68 |
| Merced, CACalifornia | $429.45 | $245.68 |
| Modesto, CACalifornia | $429.45 | $245.68 |
| Napa, CACalifornia | $500.60 | $279.61 |
| Oxnard, CACalifornia | $457.69 | $259.50 |
| Redding, CACalifornia | $429.45 | $245.68 |
| Rest of CaliforniaCalifornia | $429.45 | $245.68 |
| Riverside, CACalifornia | $433.66 | $249.90 |
| Sacramento, CACalifornia | $451.48 | $256.48 |
| Salinas, CACalifornia | $449.83 | $255.49 |
| San Diego, CACalifornia | $461.06 | $260.53 |
| Marin County, CACalifornia | $530.74 | $294.32 |
| San Francisco, CACalifornia | $530.29 | $293.87 |
| San Benito County, CACalifornia | $542.78 | $301.00 |
| Santa Clara County, CACalifornia | $540.97 | $299.19 |
| San Luis Obispo, CACalifornia | $442.52 | $251.54 |
| Santa Cruz, CACalifornia | $465.97 | $262.25 |
| Santa Maria, CACalifornia | $451.69 | $256.18 |
| Santa Rosa, CACalifornia | $470.71 | $264.81 |
| Stockton, CACalifornia | $429.45 | $245.68 |
| Vallejo, CACalifornia | $499.96 | $278.97 |
| Visalia, CACalifornia | $429.45 | $245.68 |
| Yuba City, CACalifornia | $429.45 | $245.68 |
| ColoradoColorado | $422.47 | $244.07 |
| ConnecticutConnecticut | $432.72 | $252.13 |
| DelawareDelaware | $400.30 | $234.63 |
| Fort Lauderdale, FLFlorida | $419.30 | $249.44 |
| Rest of FloridaFlorida | $398.00 | $237.70 |
| Atlanta, GAGeorgia | $412.56 | $242.21 |
| Rest of GeorgiaGeorgia | $374.49 | $224.93 |
| Hawaii, Guam, HIHawaii | $440.98 | $250.33 |
| IowaIowa | $371.13 | $217.71 |
| IdahoIdaho | $373.64 | $219.38 |
| East St. Louis, ILIllinois | $393.71 | $239.45 |
| Rest of IllinoisIllinois | $385.71 | $232.62 |
| Suburban Chicago, ILIllinois | $423.70 | $251.50 |
| IndianaIndiana | $375.94 | $220.50 |
| KansasKansas | $369.18 | $217.60 |
| KentuckyKentucky | $369.97 | $220.91 |
| New Orleans, LALouisiana | $388.66 | $230.88 |
| Rest of LouisianaLouisiana | $369.32 | $220.93 |
| Metropolitan Boston, MAMassachusetts | $465.95 | $265.75 |
| Rest of MassachusettsMassachusetts | $419.69 | $243.13 |
| Baltimore area, MDMaryland | $431.50 | $251.59 |
| Rest of MarylandMaryland | $408.28 | $238.59 |
| Rest of MaineMaine | $375.58 | $221.32 |
| Southern Maine, MEMaine | $397.28 | $231.11 |
| Detroit, MIMichigan | $403.12 | $241.31 |
| Rest of MichiganMichigan | $380.06 | $226.97 |
| MinnesotaMinnesota | $404.46 | $231.93 |
| Metropolitan Kansas City, MOMissouri | $385.98 | $228.53 |
| Metropolitan St. Louis, MOMissouri | $390.26 | $230.63 |
| Rest of MissouriMissouri | $362.54 | $218.00 |
| MississippiMississippi | $359.17 | $214.80 |
| MontanaMontana | $404.79 | $237.12 |
| North CarolinaNorth Carolina | $379.75 | $223.31 |
| North DakotaNorth Dakota | $397.08 | $229.41 |
| NebraskaNebraska | $373.31 | $218.55 |
| New HampshireNew Hampshire | $415.65 | $241.11 |
| Northern New JerseyNew Jersey | $459.87 | $265.37 |
| Rest of New JerseyNew Jersey | $437.56 | $254.46 |
| NevadaNevada | $402.95 | $235.11 |
| NYC suburbs and Long Island, NYNew York | $479.05 | $279.69 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $440.38 | $256.78 |
| Queens, NYNew York | $471.52 | $273.33 |
| Rest of New YorkNew York | $385.75 | $226.46 |
| OhioOhio | $378.48 | $225.39 |
| OklahomaOklahoma | $369.39 | $219.66 |
| Portland, OROregon | $436.63 | $250.34 |
| Rest of OregonOregon | $399.73 | $232.73 |
| Metropolitan Philadelphia, PAPennsylvania | $421.38 | $246.83 |
| Rest of PennsylvaniaPennsylvania | $379.18 | $225.26 |
| Puerto RicoPuerto Rico | $407.97 | $238.45 |
| Rhode IslandRhode Island | $415.11 | $241.91 |
| South CarolinaSouth Carolina | $379.76 | $224.84 |
| South DakotaSouth Dakota | $396.17 | $228.50 |
| TennesseeTennessee | $371.13 | $218.71 |
| Austin, TXTexas | $421.14 | $243.74 |
| Beaumont, TXTexas | $376.54 | $223.96 |
| Brazoria, TXTexas | $399.92 | $233.76 |
| Dallas, TXTexas | $402.54 | $235.54 |
| Fort Worth, TXTexas | $399.67 | $234.35 |
| Galveston, TXTexas | $401.15 | $234.65 |
| Houston, TXTexas | $408.29 | $241.79 |
| Rest of TexasTexas | $388.05 | $228.93 |
| UtahUtah | $385.25 | $227.64 |
| VirginiaVirginia | $395.82 | $231.00 |
| Virgin Islands, VIUnited States Virgin Islands | $407.97 | $238.45 |
| VermontVermont | $395.34 | $229.35 |
| Rest of WashingtonWashington | $418.96 | $242.40 |
| King County, WAWashington | $475.82 | $270.09 |
| WisconsinWisconsin | $383.04 | $222.41 |
| West VirginiaWest Virginia | $370.62 | $224.91 |
| WyomingWyoming | $401.43 | $233.76 |
69145 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$355.64
$486.12
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $462.65 | 1 |
| AL | $361.17 | 1 |
| AR | $355.64 | 1 |
| AZ | $393.52 | 1 |
| CA | $429.45–$542.78 | 29 |
| CO | $422.47 | 1 |
| CT | $432.72 | 1 |
| DC | $465.14 | 1 |
| DE | $400.30 | 1 |
| FL | $398.00–$437.20 | 3 |
| GA | $374.49–$412.56 | 2 |
| GU | $440.98 | 1 |
| HI | $440.98 | 1 |
| IA | $371.13 | 1 |
| ID | $373.64 | 1 |
| IL | $385.71–$423.82 | 4 |
| IN | $375.94 | 1 |
| KS | $369.18 | 1 |
| KY | $369.97 | 1 |
| LA | $369.32–$388.66 | 2 |
| MA | $419.69–$465.95 | 2 |
| MD | $408.28–$465.14 | 3 |
| ME | $375.58–$397.28 | 2 |
| MI | $380.06–$403.12 | 2 |
| MN | $404.46 | 1 |
| MO | $362.54–$390.26 | 3 |
| MS | $359.17 | 1 |
| MT | $404.79 | 1 |
| NC | $379.75 | 1 |
| ND | $397.08 | 1 |
| NE | $373.31 | 1 |
| NH | $415.65 | 1 |
| NJ | $437.56–$459.87 | 2 |
| NM | $382.21 | 1 |
| NV | $402.95 | 1 |
| NY | $385.75–$479.05 | 5 |
| OH | $378.48 | 1 |
| OK | $369.39 | 1 |
| OR | $399.73–$436.63 | 2 |
| PA | $379.18–$421.38 | 2 |
| PR | $407.97 | 1 |
| RI | $415.11 | 1 |
| SC | $379.76 | 1 |
| SD | $396.17 | 1 |
| TN | $371.13 | 1 |
| TX | $376.54–$421.14 | 8 |
| UT | $385.25 | 1 |
| VA | $395.82–$465.14 | 2 |
| VI | $407.97 | 1 |
| VT | $395.34 | 1 |
| WA | $418.96–$475.82 | 2 |
| WI | $383.04 | 1 |
| WV | $370.62 | 1 |
| WY | $401.43 | 1 |
How the 69145 rate is calculated
Each of 69145’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 · 69145
RVUs × geographic indexes × conversion factor
Work2.63
2.63 RVUs× 1.000 GPCI
Practice expense9.10
9.10 RVUs× 1.000 GPCI
Malpractice0.39
0.39 RVUs× 1.000 GPCI
Adjusted RVUs
12.1200
Conversion factor
$33.4009
Medicare rate
$404.82
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,589
- Code
- 69145
- Physician work
- 2.63
- Practice expense
- 9.10
- Malpractice
- 0.39
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.63 | × 1.000 | 2.6300 |
| Practice expense | 9.10 | × 0.917 | 8.3447 |
| Malpractice | 0.39 | × 1.201 | 0.4684 |
| Total RVUs | 11.4431 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$382.21
Office: (2.63 × 1 + 9.1 × 0.917 + 0.39 × 1.201) × $33.4009 = $382.21
Facility: (2.63 × 1 + 4.08 × 0.917 + 0.39 × 1.201) × $33.4009 = $228.45
Payment rules and modifiers for 69145
69145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69145
Ear canal excision, with or without tympanic membrane
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.07/0.79/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69145
Ear canal excision, with or without tympanic membrane
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69145 without 50 · national office
$404.82
Ear canal excision, with or without tympanic membrane
69145-50 · Bilateral: 150%
$607.23
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).
How 69145 has changed in New Mexico
69145 · Office / nonfacility
$382.21
Effective 2026-10-01
The base rate is $13.40 higher than on 2025-10-01, moving from $368.81 to $382.21 (3.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$368.81changed to$382.21
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.70 changed to 2.63
- Practice expense RVU 9.08 changed to 9.10
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$386.88changed to$368.81
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.31 changed to 9.08
- Malpractice RVU 0.40 changed to 0.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$380.56changed to$386.88
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$393.57changed to$380.56
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.39 changed to 9.31
- Malpractice RVU 0.38 changed to 0.40
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$398.78changed to$393.57
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.34 changed to 9.39
- Malpractice RVU 0.39 changed to 0.38
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$396.68changed to$398.78
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.18 changed to 9.34
- Malpractice RVU 0.38 changed to 0.39
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$384.67changed to$396.68
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.26 changed to 9.18
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$382.03changed to$384.67
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.05 changed to 8.26
- Malpractice RVU 0.39 changed to 0.38
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$380.50changed to$382.03
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.03 changed to 8.05
- Malpractice RVU 0.38 changed to 0.39
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$382.84changed to$380.50
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.15 changed to 8.03
- Malpractice RVU 0.39 changed to 0.38
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$386.32changed to$382.84
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.31 changed to 8.15
- Practice expense GPCI 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$386.48changed to$386.32
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.26 changed to 8.31
- Malpractice RVU 0.40 changed to 0.39
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$384.55changed to$386.48
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$384.40changed to$384.55
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.36 changed to 8.26
- Malpractice RVU 0.33 changed to 0.40
- Practice expense GPCI 0.918 changed to 0.919
- Malpractice GPCI 1.079 changed to 1.161
Held through RVU15B.
January 1, 2014
RVU14A
$393.88changed to$384.40
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.31 changed to 8.36
- Malpractice RVU 0.35 changed to 0.33
- Practice expense GPCI 0.916 changed to 0.918
- Malpractice GPCI 0.997 changed to 1.079
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $393.88
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $382.21 | $228.45 | RVU26D |
| 2026-07-01 | $382.21 | $228.45 | RVU26C |
| 2026-04-01 | $382.21 | $228.45 | RVU26B |
| 2026-01-01 | $382.21 | $228.45 | RVU26A |
| 2025-10-01 | $368.81 | $239.28 | RVU25D |
| 2025-07-01 | $368.81 | $239.28 | RVU25C |
| 2025-04-01 | $368.81 | $239.28 | RVU25B |
| 2025-01-01 | $368.81 | $239.28 | RVU25A |
| 2024-10-01 | $386.88 | $247.84 | RVU24D |
| 2024-07-01 | $386.88 | $247.84 | RVU24C |
| 2024-04-01 | $386.88 | $247.84 | RVU24B |
| 2024-03-09 | $386.88 | $247.84 | RVU24AR |
| 2024-01-01 | $380.56 | $243.80 | RVU24A |
| 2023-10-01 | $393.57 | $250.21 | RVU23D |
| 2023-07-01 | $393.57 | $250.21 | RVU23C |
| 2023-04-01 | $393.57 | $250.21 | RVU23B |
| 2023-01-01 | $393.57 | $250.21 | RVU23A |
| 2022-10-01 | $398.78 | $251.19 | RVU22D |
| 2022-07-01 | $398.78 | $251.19 | RVU22C |
| 2022-04-01 | $398.78 | $251.19 | RVU22B |
| 2022-01-01 | $398.78 | $251.19 | RVU22A |
| 2021-10-01 | $396.68 | $247.55 | RVU21D |
| 2021-07-01 | $396.68 | $247.55 | RVU21C |
| 2021-04-01 | $396.68 | $247.55 | RVU21B |
| 2021-01-01 | $396.68 | $247.55 | RVU21A |
| 2020-10-01 | $384.67 | $247.04 | RVU20D |
| 2020-07-01 | $384.67 | $247.04 | RVU20C |
| 2020-04-01 | $384.67 | $247.04 | RVU20B |
| 2020-01-01 | $384.67 | $247.04 | RVU20A |
| 2019-10-01 | $382.03 | $245.94 | RVU19D |
| 2019-07-01 | $382.03 | $245.94 | RVU19C |
| 2019-04-01 | $382.03 | $245.94 | RVU19B |
| 2019-01-01 | $382.03 | $245.94 | RVU19A |
| 2018-10-01 | $380.50 | $244.89 | RVU18D |
| 2018-07-01 | $380.50 | $244.89 | RVU18C |
| 2018-04-01 | $380.50 | $244.89 | RVU18B |
| 2018-01-01 | $380.50 | $244.89 | RVU18AR1 |
| 2017-10-01 | $382.84 | $246.81 | RVU17D |
| 2017-07-01 | $382.84 | $246.81 | RVU17C |
| 2017-04-01 | $382.84 | $246.81 | RVU17B |
| 2017-01-01 | $382.84 | $246.81 | RVU17A |
| 2016-10-01 | $386.32 | $248.45 | RVU16D |
| 2016-07-01 | $386.32 | $248.45 | RVU16C |
| 2016-04-01 | $386.32 | $248.45 | RVU16B |
| 2016-01-01 | $386.32 | $248.45 | RVU16A |
| 2015-10-01 | $386.48 | $247.78 | RVU15D |
| 2015-07-01 | $386.48 | $247.78 | RVU15C |
| 2015-04-01 | $384.55 | $246.55 | RVU15B |
| 2015-01-01 | $384.55 | $246.55 | RVU15A |
| 2014-10-01 | $384.40 | $246.28 | RVU14D |
| 2014-07-01 | $384.40 | $246.28 | RVU14C |
| 2014-04-01 | $384.40 | $246.28 | RVU14B |
| 2014-01-01 | $384.40 | $246.28 | RVU14A |
| 2013-10-01 | $393.88 | $247.09 | RVU13D |
| 2013-07-01 | $393.88 | $247.09 | RVU13C |
| 2013-04-01 | $393.88 | $247.09 | RVU13B |
| 2013-01-01 | $393.88 | $247.09 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
69145 billing questions
How is this different from 69140?
69140 is for a simple external auditory canal lesion excision. Use 69145 when the documented service fits the canal excision level represented by this code, including its tympanic membrane qualifier.
When should 69105 be reported instead?
69105 describes biopsy of an external auditory canal lesion. Choose 69145 when the operative service is excision of the lesion, not merely obtaining tissue for diagnosis.
What documentation supports this code?
Document the lesion’s external auditory canal location, the extent of the excision, tissues removed, and whether the tympanic membrane was involved.
Can modifier 50 be used when both ears are treated?
Yes. CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%.
Does the code include postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS restricts assistant-at-surgery payment 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
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