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CPT code 69145: Ear canal excision, with or without tympanic membrane2026 Medicare rate & RVUs in Houston, TX

Reports operative excision of a lesion in the external auditory canal, including cases where the tympanic membrane is involved or removed.

CMS RVU26DEffective Oct 1, 2026One payment locality2.8K Medicare services in 2024

In Houston, TX, Medicare pays $408.29 for 69145 in the office and $241.79 when it’s performed in a hospital or facility.

$408.29Office (non-facility)
$241.79Hospital or facility
+0.9%vs the national office rate ($404.82)

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.

We’ll open 69145 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 69145 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 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 Houston, TX 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. Houston, TX pays $408.29. The RVUs are the same everywhere; the geographic indexes change the dollars.

69145 in Houston, TX vs other payment areas
  1. Houston, TX · this page$408.29
  2. Austin, TX · Texas$421.14+$12.85
  3. Beaumont, TX · Texas$376.54−$31.75
  4. Brazoria, TX · Texas$399.92−$8.37
  5. Dallas, TX · Texas$402.54−$5.75
  6. Fort Worth, TX · Texas$399.67−$8.62
  7. Galveston, TX · Texas$401.15−$7.14

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

Every other payment area

69145 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$388.05$228.93
Los Angeles, CACalifornia$459.67$261.31
Washington, DC areaDistrict of Columbia$465.14$267.62
Miami, FLFlorida$437.20$262.65
Chicago, ILIllinois$423.82$255.31
Manhattan, NYNew York$467.31$272.48
AlaskaAlaska$462.65$284.08
AlabamaAlabama$361.17$214.46

69145 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.

$355.64

$486.12

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

View every state and territory as a table
69145 office rate range by state
State / territoryOffice rate rangeLocalities
AK$462.651
AL$361.171
AR$355.641
AZ$393.521
CA$429.45–$542.7829
CO$422.471
CT$432.721
DC$465.141
DE$400.301
FL$398.00–$437.203
GA$374.49–$412.562
GU$440.981
HI$440.981
IA$371.131
ID$373.641
IL$385.71–$423.824
IN$375.941
KS$369.181
KY$369.971
LA$369.32–$388.662
MA$419.69–$465.952
MD$408.28–$465.143
ME$375.58–$397.282
MI$380.06–$403.122
MN$404.461
MO$362.54–$390.263
MS$359.171
MT$404.791
NC$379.751
ND$397.081
NE$373.311
NH$415.651
NJ$437.56–$459.872
NM$382.211
NV$402.951
NY$385.75–$479.055
OH$378.481
OK$369.391
OR$399.73–$436.632
PA$379.18–$421.382
PR$407.971
RI$415.111
SC$379.761
SD$396.171
TN$371.131
TX$376.54–$421.148
UT$385.251
VA$395.82–$465.142
VI$407.971
VT$395.341
WA$418.96–$475.822
WI$383.041
WV$370.621
WY$401.431

See 69145 in every payment locality

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

Office or facility?

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 69145 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.63× 1.0082.6510
Practice expense9.10× 0.9939.0363
Malpractice0.39× 1.3760.5366
Total RVUs12.2240
Conversion factor× 33.4009

Office rate, Houston, TX$408.29

Office: (2.63 × 1.008 + 9.1 × 0.993 + 0.39 × 1.376) × $33.4009 = $408.29

Facility: (2.63 × 1.008 + 4.08 × 0.993 + 0.39 × 1.376) × $33.4009 = $241.79

Open 69145 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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.
Split (54/55/56)0.07/0.79/0.14Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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).

When to use modifier 50

Codes related to 69145

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

Codes related to 69145
CodeHow it relatesOffice range, Houston, TX
Same family
69140Ear canal excision, lesion removalSibling code for simple excision of an external auditory canal lesion.No office rate
69150Ear canal surgery, extensive excisionSibling code for extensive external auditory canal lesion surgery.No office rate
69155Ear canal surgery, extensive with neck surgerySibling code for extensive canal surgery with or without tympanic membrane involvement.No office rate
Used instead
69105Ear canal biopsy, external auditory canalUse for biopsy of an external auditory canal lesion rather than excision.$144.77

How 69145 has changed in Houston, TX

69145 · Office / nonfacility

$408.29

Effective 2026-10-01

The base rate is $7.37 higher than on 2025-10-01, moving from $400.92 to $408.29 (1.8%).

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

    $400.92changed to$408.29

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $420.73changed to$400.92

    • 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.

  3. March 9, 2024

    RVU24AR

    $413.86changed to$420.73

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $431.75changed to$413.86

    • 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
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $441.17changed to$431.75

    • 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
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $438.77changed to$441.17

    • 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.

  7. January 1, 2021

    RVU21A

    $416.63changed to$438.77

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.26 changed to 9.18
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $406.00changed to$416.63

    • 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
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $404.49changed to$406.00

    • 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.

  10. January 1, 2018

    RVU18AR1

    $407.20changed to$404.49

    • 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 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $411.16changed to$407.20

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.31 changed to 8.15
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $411.18changed to$411.16

    • 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.

  13. July 1, 2015

    RVU15C

    $409.14changed to$411.18

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $409.85changed to$409.14

    • 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
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $421.07changed to$409.85

    • 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
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $421.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$408.29$241.79RVU26D
2026-07-01$408.29$241.79RVU26C
2026-04-01$408.29$241.79RVU26B
2026-01-01$408.29$241.79RVU26A
2025-10-01$400.92$257.84RVU25D
2025-07-01$400.92$257.84RVU25C
2025-04-01$400.92$257.84RVU25B
2025-01-01$400.92$257.84RVU25A
2024-10-01$420.73$267.15RVU24D
2024-07-01$420.73$267.15RVU24C
2024-04-01$420.73$267.15RVU24B
2024-03-09$420.73$267.15RVU24AR
2024-01-01$413.86$262.79RVU24A
2023-10-01$431.75$270.28RVU23D
2023-07-01$431.75$270.28RVU23C
2023-04-01$431.75$270.28RVU23B
2023-01-01$431.75$270.28RVU23A
2022-10-01$441.17$271.67RVU22D
2022-07-01$441.17$271.67RVU22C
2022-04-01$441.17$271.67RVU22B
2022-01-01$441.17$271.67RVU22A
2021-10-01$438.77$267.50RVU21D
2021-07-01$438.77$267.50RVU21C
2021-04-01$438.77$267.50RVU21B
2021-01-01$438.77$267.50RVU21A
2020-10-01$416.63$262.02RVU20D
2020-07-01$416.63$262.02RVU20C
2020-04-01$416.63$262.02RVU20B
2020-01-01$416.63$262.02RVU20A
2019-10-01$406.00$256.47RVU19D
2019-07-01$406.00$256.47RVU19C
2019-04-01$406.00$256.47RVU19B
2019-01-01$406.00$256.47RVU19A
2018-10-01$404.49$255.49RVU18D
2018-07-01$404.49$255.49RVU18C
2018-04-01$404.49$255.49RVU18B
2018-01-01$404.49$255.49RVU18AR1
2017-10-01$407.20$258.01RVU17D
2017-07-01$407.20$258.01RVU17C
2017-04-01$407.20$258.01RVU17B
2017-01-01$407.20$258.01RVU17A
2016-10-01$411.16$260.24RVU16D
2016-07-01$411.16$260.24RVU16C
2016-04-01$411.16$260.24RVU16B
2016-01-01$411.16$260.24RVU16A
2015-10-01$411.18$259.36RVU15D
2015-07-01$411.18$259.36RVU15C
2015-04-01$409.14$258.07RVU15B
2015-01-01$409.14$258.07RVU15A
2014-10-01$409.85$258.80RVU14D
2014-07-01$409.85$258.80RVU14C
2014-04-01$409.85$258.80RVU14B
2014-01-01$409.85$258.80RVU14A
2013-10-01$421.07$260.50RVU13D
2013-07-01$421.07$260.50RVU13C
2013-04-01$421.07$260.50RVU13B
2013-01-01$421.07$260.50RVU13AR

Price 69145 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for 69145PPRRVU2026_Oct_nonQPP.csv, line 7,589 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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