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

Report this code for irrigation or lavage to remove impacted cerumen from one ear canal, rather than instrumentation or routine ear cleaning.

CMS RVU26DEffective Oct 1, 2026One payment locality276.8K Medicare services in 2024

In Utah, Medicare pays $16.00 for 69209 in the office.

$16.00Office (non-facility)
Not available in this settingHospital or facility
−6.0%vs the national office rate ($17.03)

Check a contract rate as a % of Medicare · 69209 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 69209 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 69209 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 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.

How Utah compares for 69209

Across 109 of 109 payment localities, the office rate for 69209 runs from $14.52 in Arkansas to $24.26 in San Benito County, CA. Utah pays $16.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

69209 in Utah vs other payment areas
  1. Utah · this page$16.00
  2. Los Angeles, CA · California$19.98+$3.98
  3. Washington, DC area · District of Columbia$20.04+$4.04
  4. Miami, FL · Florida$18.23+$2.23
  5. Chicago, IL · Illinois$17.55+$1.55
  6. Manhattan, NY · New York$19.94+$3.94
  7. Alaska · Alaska$17.97+$1.97

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

Every other payment area

69209 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$14.80—
ArkansasArkansas$14.52—
ArizonaArizona$16.47—
Bakersfield, CACalifornia$18.51—
Chico, CACalifornia$18.48—
El Centro, CACalifornia$18.48—
Fresno, CACalifornia$18.48—
Hanford, CACalifornia$18.48—

69209 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.

$14.52

$21.37

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

View every state and territory as a table
69209 office rate range by state
State / territoryOffice rate rangeLocalities
AK$17.971
AL$14.801
AR$14.521
AZ$16.471
CA$18.48–$24.2629
CO$18.031
CT$18.391
DC$20.041
DE$16.801
FL$16.47–$18.233
GA$15.29–$17.372
GU$19.181
HI$19.181
IA$15.411
ID$15.521
IL$15.77–$17.744
IN$15.641
KS$15.271
KY$15.151
LA$15.10–$16.092
MA$17.85–$20.242
MD$17.21–$20.043
ME$15.57–$16.762
MI$15.62–$16.682
MN$17.281
MO$14.72–$16.233
MS$14.631
MT$17.031
NC$15.791
ND$16.841
NE$15.541
NH$17.681
NJ$18.60–$19.732
NM$15.721
NV$17.001
NY$16.10–$20.485
OH$15.581
OK$15.171
OR$16.87–$18.802
PA$15.65–$17.782
PR$17.211
RI$17.551
SC$15.721
SD$16.811
TN$15.361
TX$15.51–$17.978
UT$16.001
VA$16.65–$20.042
VI$17.211
VT$16.701
WA$17.84–$20.762
WI$16.101
WV$14.991
WY$16.951

See 69209 in every payment locality

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

Office or facility?

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.

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,594

Code
69209
Physician work
0.00
Practice expense
0.50
Malpractice
0.01

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 69209 in Utah
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense0.50× 0.9400.4700
Malpractice0.01× 0.8980.0090
Total RVUs0.4790
Conversion factor× 33.4009

Office rate, Utah$16.00

Office: (0 × 1 + 0.5 × 0.94 + 0.01 × 0.898) × $33.4009 = $16.00

Open 69209 in the RVU calculator

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

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/technical5Incident-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).

When to use modifier 50

How 69209 has changed in Utah

69209 · Office / nonfacility

$16.00

Effective 2026-10-01

The base rate is $1.82 higher than on 2025-10-01, moving from $14.18 to $16.00 (12.8%).

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

    $14.18changed to$16.00

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.46 changed to 0.50
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $14.91changed to$14.18

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.47 changed to 0.46

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $14.66changed to$14.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $14.41changed to$14.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.45 changed to 0.47
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930
  5. January 1, 2023

    RVU23A

    $14.27changed to$14.41

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.44 changed to 0.45
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $14.07changed to$14.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.43 changed to 0.44

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $13.35changed to$14.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.39 changed to 0.43
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $13.45changed to$13.35

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $13.43changed to$13.45

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $12.04changed to$13.43

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.35 changed to 0.39
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $11.97changed to$12.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$11.97

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$16.00Not available in this settingRVU26D
2026-07-01$16.00Not available in this settingRVU26C
2026-04-01$16.00Not available in this settingRVU26B
2026-01-01$16.00Not available in this settingRVU26A
2025-10-01$14.18Not available in this settingRVU25D
2025-07-01$14.18Not available in this settingRVU25C
2025-04-01$14.18Not available in this settingRVU25B
2025-01-01$14.18Not available in this settingRVU25A
2024-10-01$14.91Not available in this settingRVU24D
2024-07-01$14.91Not available in this settingRVU24C
2024-04-01$14.91Not available in this settingRVU24B
2024-03-09$14.91Not available in this settingRVU24AR
2024-01-01$14.66Not available in this settingRVU24A
2023-10-01$14.41Not available in this settingRVU23D
2023-07-01$14.41Not available in this settingRVU23C
2023-04-01$14.41Not available in this settingRVU23B
2023-01-01$14.41Not available in this settingRVU23A
2022-10-01$14.27Not available in this settingRVU22D
2022-07-01$14.27Not available in this settingRVU22C
2022-04-01$14.27Not available in this settingRVU22B
2022-01-01$14.27Not available in this settingRVU22A
2021-10-01$14.07Not available in this settingRVU21D
2021-07-01$14.07Not available in this settingRVU21C
2021-04-01$14.07Not available in this settingRVU21B
2021-01-01$14.07Not available in this settingRVU21A
2020-10-01$13.35Not available in this settingRVU20D
2020-07-01$13.35Not available in this settingRVU20C
2020-04-01$13.35Not available in this settingRVU20B
2020-01-01$13.35Not available in this settingRVU20A
2019-10-01$13.45Not available in this settingRVU19D
2019-07-01$13.45Not available in this settingRVU19C
2019-04-01$13.45Not available in this settingRVU19B
2019-01-01$13.45Not available in this settingRVU19A
2018-10-01$13.43Not available in this settingRVU18D
2018-07-01$13.43Not available in this settingRVU18C
2018-04-01$13.43Not available in this settingRVU18B
2018-01-01$13.43Not available in this settingRVU18AR1
2017-10-01$12.04Not available in this settingRVU17D
2017-07-01$12.04Not available in this settingRVU17C
2017-04-01$12.04Not available in this settingRVU17B
2017-01-01$12.04Not available in this settingRVU17A
2016-10-01$11.97Not available in this settingRVU16D
2016-07-01$11.97Not available in this settingRVU16C
2016-04-01$11.97Not available in this settingRVU16B
2016-01-01$11.97Not available in this settingRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 69209 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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
RVUs for 69209PPRRVU2026_Oct_nonQPP.csv, line 7,594 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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