CPT code 69200: Ear canal removal, without general anesthesia2026 Medicare rate & RVUs in Maryland

Report 69200 when a clinician removes a discrete foreign object from the external ear canal without general anesthesia, such as a bead or insect.

CMS RVU26DEffective Oct 1, 20263 payment localities48.5K Medicare services in 2024

Medicare pays $82.42–$93.05 for 69200 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.

$82.42–$93.05Office (non-facility)
$41.86–$45.84Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Maryland
  2. What 69200 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 69200 covers

This service covers removing a discrete object lodged in the external auditory canal, such as a bead in a child’s ear or an insect. A primary care clinician, emergency physician, or otolaryngologist may remove it with an instrument or another appropriate technique in an office, emergency department, or facility. The distinguishing feature is that the removal is performed without general anesthesia; removal under general anesthesia is represented by a different code.

Document the affected ear, the foreign object, the removal method, and the anesthesia circumstances. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral removal, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Medicare does not pay an assistant at surgery for this service; 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.

Where 69200 pays more and less in Maryland

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$82.42 to $93.05

$82.42$87.73$93.05
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
69200 office and facility rates by payment locality
Payment localityOfficeFacility
Baltimore area, MD$86.98$43.97
Rest of Maryland$82.42$41.86
Washington, DC area$93.05$45.84

How the 69200 rate is calculated

Each of 69200’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 · 69200

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.75

0.75 RVUs× 1.000 GPCI

Practice expense1.59

1.59 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

2.4500

Conversion factor

$33.4009

Medicare rate

$81.83

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

Payment rules and modifiers for 69200

The CMS indicators that decide how 69200 is paid alongside other services.

CMS payment indicators · 69200

Ear canal removal, without general anesthesia

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

69200 without 50 · national office

$81.83

Ear canal removal, without general anesthesia

69200-50 · Bilateral: 150%

$122.75

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

69200 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 69200

    Ear canal removal, without general anesthesia0.75 wRVU

    $81.83

  • 69205

    Ear foreign body removal, with general anesthesia1.18 wRVU

    Not priced

  • 69209

    Earwax removal, irrigation or lavage0 wRVU

    $17.03−$64.80

  • 69210

    Impacted ear wax removal, instrumentation, unilateral0.59 wRVU

    $47.76−$34.07

How to choose

69205Ear foreign body removalWith general anesthesia
Both codes describe external ear canal foreign-body removal. The anesthesia circumstance distinguishes them: 69200 is without general anesthesia; 69205 is with it.
69209Earwax removalIrrigation or lavage
69209 is for impacted cerumen removed by irrigation or lavage. A bead, insect, or other discrete foreign object supports 69200 instead.
69210Impacted ear wax removalInstrumentation, unilateral
69210 is for impacted cerumen removed with instrumentation. Use 69200 for a discrete foreign object rather than earwax.

69200 billing questions

How does 69200 differ from 69205?

69200 is for foreign-body removal without general anesthesia. Use 69205 when removal is performed under general anesthesia.

Can 69200 be reported for impacted earwax?

No. For impacted cerumen, choose the cerumen-removal code that matches the method: irrigation or lavage versus instrumentation.

How is removal from both ears reported?

For bilateral removal, report modifier 50; Medicare pays the bilateral procedure at 150%.

Is same-day evaluation separately included?

The code has a 0-day global period, which includes same-day preoperative and postoperative care.

What documentation supports 69200?

Record the ear treated, the discrete foreign object removed, the technique, and whether general anesthesia was used.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. Medicare does not pay an assistant at surgery, and co-surgeons or 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 69200PPRRVU2026_Oct_nonQPP.csv, line 7,592 (RVU26D)

Open CMS sourceHow we calculate rates

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