CPT code 69421: Myringotomy, general anesthesia, no tube2026 Medicare rate & RVUs in Virgin Islands, VI

Reports an eardrum incision to access or drain the middle ear when the myringotomy is performed under general anesthesia, without tube placement.

CMS RVU26DEffective Oct 1, 2026One payment locality365 Medicare services in 2024

In Virgin Islands, VI, Medicare pays $138.61 for 69421 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$138.61Hospital or facility

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.

We’ll open 69421 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virgin Islands, VI
  2. What 69421 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 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 Virgin Islands, VI 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. Virgin Islands, VI pays $138.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

69421 in Virgin Islands, VI vs other payment areas
  1. Virgin Islands, VI · this page$138.61
  2. Los Angeles, CA · California$150.60+$11.99
  3. Washington, DC area · District of Columbia$154.75+$16.14
  4. Miami, FL · Florida$153.64+$15.03
  5. Chicago, IL · Illinois$149.52+$10.91
  6. Manhattan, NY · New York$158.14+$19.53
  7. Alaska · Alaska$167.90+$29.29

Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.

Every other payment area

69421 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$125.39
ArkansasArkansas—$123.82
ArizonaArizona—$134.53
Bakersfield, CACalifornia—$142.65
Chico, CACalifornia—$141.92
El Centro, CACalifornia—$141.96
Fresno, CACalifornia—$141.92
Hanford, CACalifornia—$141.92

69421 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

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69421 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

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.

How the rate is built · 69421

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.74

1.74 RVUs× 1.000 GPCI

Practice expense2.14

2.14 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

4.1300

Conversion factor

$33.4009

Medicare rate

$137.95

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

The exact Virgin Islands, VI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,603

Code
69421
Physician work
1.74
Practice expense
2.14
Malpractice
0.25

GPCI2026.csv

107

Locality
Virgin Islands, VI
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Facility calculation for 69421 in Virgin Islands, VI
ComponentRVULocality factorAdjusted
Physician work1.74× 1.0001.7400
Practice expense2.14× 1.0112.1635
Malpractice0.25× 0.9850.2462
Total RVUs4.1498
Conversion factor× 33.4009

Facility rate, Virgin Islands, VI$138.61

Facility: (1.74 × 1 + 2.14 × 1.011 + 0.25 × 0.985) × $33.4009 = $138.61

Open 69421 in the RVU calculator

Payment rules and modifiers for 69421

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

CMS payment indicators · 69421

Myringotomy, general anesthesia, no tube

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are 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.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 69421

Myringotomy, general anesthesia, no tube

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

69421 without 50 · national facility

$137.95

Myringotomy, general anesthesia, no tube

69421-50 · Bilateral: 150%

$206.93

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 69421 has changed in Virgin Islands, VI

69421 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$138.61RVU26D
2026-07-01Not available in this setting$138.61RVU26C
2026-04-01Not available in this setting$138.61RVU26B
2026-01-01Not available in this setting$138.61RVU26A
2025-10-01Not available in this setting$148.90RVU25D
2025-07-01Not available in this setting$148.90RVU25C
2025-04-01Not available in this setting$148.90RVU25B
2025-01-01Not available in this setting$148.90RVU25A
2024-10-01Not available in this setting$153.24RVU24D
2024-07-01Not available in this setting$153.24RVU24C
2024-04-01Not available in this setting$153.24RVU24B
2024-03-09Not available in this setting$153.24RVU24AR
2024-01-01Not available in this setting$150.74RVU24A
2023-10-01Not available in this setting$155.76RVU23D
2023-07-01Not available in this setting$155.20RVU23C
2023-04-01Not available in this setting$155.20RVU23B
2023-01-01Not available in this setting$155.20RVU23A
2022-10-01Not available in this setting$156.29RVU22D
2022-07-01Not available in this setting$156.29RVU22C
2022-04-01Not available in this setting$156.29RVU22B
2022-01-01Not available in this setting$156.29RVU22A
2021-10-01Not available in this setting$153.37RVU21D
2021-07-01Not available in this setting$153.37RVU21C
2021-04-01Not available in this setting$153.37RVU21B
2021-01-01Not available in this setting$153.37RVU21A
2020-10-01Not available in this setting$152.46RVU20D
2020-07-01Not available in this setting$152.46RVU20C
2020-04-01Not available in this setting$152.46RVU20B
2020-01-01Not available in this setting$152.46RVU20A
2019-10-01Not available in this setting$152.54RVU19D
2019-07-01Not available in this setting$152.54RVU19C
2019-04-01Not available in this setting$152.54RVU19B
2019-01-01Not available in this setting$152.54RVU19A
2018-10-01Not available in this setting$151.65RVU18D
2018-07-01Not available in this setting$151.65RVU18C
2018-04-01Not available in this setting$151.65RVU18B
2018-01-01Not available in this setting$151.65RVU18AR1
2017-10-01Not available in this setting$152.94RVU17D
2017-07-01Not available in this setting$152.94RVU17C
2017-04-01Not available in this setting$152.94RVU17B
2017-01-01Not available in this setting$152.94RVU17A
2016-10-01Not available in this setting$150.68RVU16D
2016-07-01Not available in this setting$150.68RVU16C
2016-04-01Not available in this setting$150.68RVU16B
2016-01-01Not available in this setting$150.68RVU16A
2015-10-01Not available in this setting$151.24RVU15D
2015-07-01Not available in this setting$151.24RVU15C
2015-04-01Not available in this setting$150.49RVU15B
2015-01-01Not available in this setting$150.49RVU15A
2014-10-01Not available in this setting$153.67RVU14D
2014-07-01Not available in this setting$153.67RVU14C
2014-04-01Not available in this setting$153.67RVU14B
2014-01-01Not available in this setting$153.67RVU14A
2013-10-01Not available in this setting$154.37RVU13D
2013-07-01Not available in this setting$154.37RVU13C
2013-04-01Not available in this setting$154.37RVU13B
2013-01-01Not available in this setting$154.37RVU13AR

Price 69421 for an earlier date of service

Where the Virgin Islands, VI rate applies

Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.

  • Charlotte Amalie
  • Charlotte Amalie East
  • Charlotte Amalie West
  • Christiansted
  • Coral Bay
  • Cruz Bay
  • Frederiksted
  • Frederiksted Southeast

Browse all communities in United States Virgin Islands

69421 billing questions

How does 69421 differ from 69420?

Both describe a myringotomy without tube placement. Use 69421 when the procedure requires general anesthesia; 69420 is the corresponding service without that anesthesia distinction.

Should 69421 be reported when a ventilating tube is inserted?

Use the applicable tube-placement code when a ventilating tube is inserted. 69421 describes the incision and middle-ear access without tube placement.

Can the service be reported for both ears?

For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.

Are postoperative visits separately payable during the global period?

Related postoperative visits for 10 days are included in the 10-day global period.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for 69421. Co-surgeons and team surgery are not permitted.

What happens if another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 69421PPRRVU2026_Oct_nonQPP.csv, line 7,603 (RVU26D)
Geographic factors for Virgin Islands, VIGPCI2026.csv, line 107 (RVU26D)

Open CMS sourceHow we calculate rates

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