CPT code 69209: Earwax removal, irrigation or lavage2026 Medicare rate & RVUs

Medicare pays $17.03 for 69209 nationally in the office. Local office rates run $14.52–$24.26.

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

What 69209 covers

This service uses irrigation or lavage to dislodge and remove impacted cerumen from one external ear canal. It is commonly performed in an office or clinic when wax obstructs the canal; clinical staff may perform the irrigation under physician supervision. It describes wax removal, not routine ear cleaning or extraction of a foreign body. The instrumentation method for impacted cerumen is reported with a different code.

Report one unit for one ear; report bilateral treatment with modifier 50. CMS applies a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. As an incident-to service, this code is billed only when performed under physician supervision. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing 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 69209 pays more and less

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

109 of 109 payment localities

69209 rates by state

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

How the 69209 rate is calculated

Each of 69209’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.

Payment rules and modifiers for 69209

The CMS indicators that decide how 69209 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

69209 compared with similar codes

How to choose

69210Impacted ear wax removalInstrumentation, unilateral

Both codes address impacted cerumen, but 69209 is for irrigation or lavage and 69210 is for removal requiring instrumentation.

69200Ear canal removalWithout general anesthesia

Use 69200 for a foreign body in the external ear canal removed without general anesthesia; 69209 is for impacted cerumen removed by irrigation or lavage.

69205Ear foreign body removalWith general anesthesia

Use 69205 for external ear canal foreign-body removal with general anesthesia. It is not the irrigation method for impacted cerumen described by 69209.

Codes related to 69209

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

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

Open CMS sourceHow we calculate rates