CPT code 69209: Earwax removal, irrigation or lavage2026 Medicare rate & RVUs in Missouri
Report this code for irrigation or lavage to remove impacted cerumen from one ear canal, rather than instrumentation or routine ear cleaning.
Medicare pays $14.72–$16.23 for 69209 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$14.72 to $16.23
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $16.01 | Unavailable |
| Metropolitan St. Louis, MO | $16.23 | Unavailable |
| Rest of Missouri | $14.72 | Unavailable |
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.
How the rate is built · 69209
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.50
0.50 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.5100
Conversion factor
$33.4009
Medicare rate
$17.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69209
The CMS indicators that decide how 69209 is paid alongside other services.
CMS payment indicators · 69209
Earwax removal, irrigation or lavage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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 | 5 | Incident-to service. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69209 without 50 · national office
$17.03
Earwax removal, irrigation or lavage
69209-50 · Bilateral: 150%
$25.55
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).
69209 compared with similar codes
Compare codes · National
4 codes, side by side
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.
69209 billing questions
How is this different from 69210?
Use 69209 when impacted cerumen is removed by irrigation or lavage. Use 69210 when removal requires instrumentation.
Can the code be reported for both ears?
Yes. The code is unilateral; report bilateral treatment with modifier 50. CMS pays a bilateral procedure reported with modifier 50 at 150%.
Can clinical staff perform the irrigation?
The service may be performed as an incident-to service, but it may be billed only when performed under physician supervision.
Is this the right code for a foreign object in the ear canal?
No. This code is for impacted cerumen removed by irrigation or lavage. Foreign-body removal is reported with 69200 or 69205, depending on the circumstances.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and the other procedure at 50% under the standard multiple procedure reduction.
Is same-day follow-up care included?
Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
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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