CPT code 69421: Myringotomy, general anesthesia, no tube2026 Medicare rate & RVUs in Virginia

In Virginia, Medicare pays $134.28 for 69421 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 69421 nationwide

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

What 69421 covers

An otolaryngologist makes an opening in the tympanic membrane to access or drain the middle ear, often for middle-ear fluid or pressure problems. The service may include aspiration of middle-ear contents. This code is for a myringotomy performed under general anesthesia and does not represent placement of a ventilating tube. It is commonly performed in an operating room or ambulatory surgery setting, including for patients who cannot tolerate the procedure awake.

Report the service when the operative documentation supports the eardrum incision and general anesthesia; distinguish it from a myringotomy performed without general anesthesia and from procedures that also place a tube. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 Virginia compares for 69421

Across 109 of 109 payment localities, the facility rate for 69421 runs from $123.82 in Arkansas to $172.06 in San Benito County, CA. Virginia pays $134.28. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

69421 rates by state

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

See 69421 in every payment locality

How the 69421 rate is calculated

Each of 69421’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 69421

69421 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 69421

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

How 69421 has changed in Virginia

Price 69421 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

• Abbs Valley
• Abingdon
• Accomac
• Adwolf
• Afton
• Alberta
• Aldie
• Allison Gap

Browse all communities in Virginia

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