CPT code 69424: Tube removal, requires general anesthesia2026 Medicare rate & RVUs in Iowa
Reports removal of a tympanostomy tube when the procedure requires general anesthesia, such as removal of a retained tube in an operating room.
In Iowa, Medicare pays $119.99 for 69424 in the office and $51.53 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 69424 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 69424 covers
This service covers removal of a ventilating tube from the tympanic membrane when general anesthesia is required. An otolaryngologist typically performs it in an operating room, often for a retained tube or when a child cannot tolerate removal while awake. The operative record should identify the ear, the tube removed, and the clinical reason for removal, and should support the need for general anesthesia.
Report the service for the tube removal itself, not for making an opening in the eardrum or placing a new tube. The CMS global period is zero days, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral removal, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 Iowa compares for 69424
Across 109 of 109 payment localities, the office rate for 69424 runs from $114.77 in Arkansas to $175.91 in San Benito County, CA. Iowa pays $119.99. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$119.99
- Los Angeles, CA · California$148.60+$28.61
- Washington, DC area · District of Columbia$149.82+$29.83
- Miami, FL · Florida$138.94+$18.95
- Chicago, IL · Illinois$134.85+$14.86
- Manhattan, NY · New York$149.92+$29.93
- Alaska · Alaska$149.24+$29.25
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $116.52 | $51.05 |
| ArkansasArkansas | $114.77 | $50.50 |
| ArizonaArizona | $126.75 | $54.25 |
| Bakersfield, CACalifornia | $139.17 | $57.17 |
| Chico, CACalifornia | $138.90 | $56.89 |
| El Centro, CACalifornia | $138.91 | $56.91 |
| Fresno, CACalifornia | $138.90 | $56.89 |
| Hanford, CACalifornia | $138.90 | $56.89 |
| Madera, CACalifornia | $138.90 | $56.89 |
| Merced, CACalifornia | $138.90 | $56.89 |
| Modesto, CACalifornia | $138.90 | $56.89 |
| Napa, CACalifornia | $162.18 | $63.57 |
| Oxnard, CACalifornia | $148.02 | $59.59 |
| Redding, CACalifornia | $138.90 | $56.89 |
| Rest of CaliforniaCalifornia | $138.90 | $56.89 |
| Riverside, CACalifornia | $139.88 | $57.88 |
| Sacramento, CACalifornia | $146.09 | $59.08 |
| Salinas, CACalifornia | $145.55 | $58.84 |
| San Diego, CACalifornia | $149.23 | $59.74 |
| Marin County, CACalifornia | $172.08 | $66.59 |
| San Francisco, CACalifornia | $171.98 | $66.48 |
| San Benito County, CACalifornia | $175.91 | $68.02 |
| Santa Clara County, CACalifornia | $175.49 | $67.61 |
| San Luis Obispo, CACalifornia | $143.18 | $57.96 |
| Santa Cruz, CACalifornia | $150.85 | $59.95 |
| Santa Maria, CACalifornia | $146.17 | $58.93 |
| Santa Rosa, CACalifornia | $152.39 | $60.52 |
| Stockton, CACalifornia | $138.90 | $56.89 |
| Vallejo, CACalifornia | $162.04 | $63.43 |
| Visalia, CACalifornia | $138.90 | $56.89 |
| Yuba City, CACalifornia | $138.90 | $56.89 |
| ColoradoColorado | $136.31 | $56.70 |
| ConnecticutConnecticut | $139.11 | $58.53 |
| DelawareDelaware | $128.90 | $54.98 |
| Fort Lauderdale, FLFlorida | $133.99 | $58.20 |
| Rest of FloridaFlorida | $127.40 | $55.87 |
| Atlanta, GAGeorgia | $132.54 | $56.53 |
| Rest of GeorgiaGeorgia | $120.09 | $53.35 |
| Hawaii, Guam, HIHawaii | $142.63 | $57.57 |
| IdahoIdaho | $120.72 | $51.88 |
| East St. Louis, ILIllinois | $125.35 | $56.52 |
| Rest of IllinoisIllinois | $123.30 | $54.99 |
| Suburban Chicago, ILIllinois | $135.47 | $58.63 |
| IndianaIndiana | $121.45 | $52.10 |
| KansasKansas | $119.22 | $51.58 |
| KentuckyKentucky | $118.96 | $52.45 |
| New Orleans, LALouisiana | $124.80 | $54.40 |
| Rest of LouisianaLouisiana | $118.69 | $52.48 |
| Metropolitan Boston, MAMassachusetts | $150.38 | $61.05 |
| Rest of MassachusettsMassachusetts | $135.37 | $56.59 |
| Baltimore area, MDMaryland | $138.69 | $58.41 |
| Rest of MarylandMaryland | $131.49 | $55.77 |
| Rest of MaineMaine | $121.16 | $52.33 |
| Southern Maine, MEMaine | $128.26 | $54.11 |
| Detroit, MIMichigan | $128.84 | $56.64 |
| Rest of MichiganMichigan | $121.99 | $53.68 |
| MinnesotaMinnesota | $131.03 | $54.05 |
| Metropolitan Kansas City, MOMissouri | $124.12 | $53.87 |
| Metropolitan St. Louis, MOMissouri | $125.49 | $54.27 |
| Rest of MissouriMissouri | $116.45 | $51.96 |
| MississippiMississippi | $115.64 | $51.23 |
| MontanaMontana | $130.26 | $55.44 |
| North CarolinaNorth Carolina | $122.51 | $52.70 |
| North DakotaNorth Dakota | $128.48 | $53.66 |
| NebraskaNebraska | $120.73 | $51.67 |
| New HampshireNew Hampshire | $133.97 | $56.08 |
| Northern New JerseyNew Jersey | $148.14 | $61.35 |
| Rest of New JerseyNew Jersey | $140.82 | $59.12 |
| New MexicoNew Mexico | $122.61 | $54.00 |
| NevadaNevada | $129.86 | $54.97 |
| NYC suburbs and Long Island, NYNew York | $153.43 | $64.47 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $141.60 | $59.67 |
| Queens, NYNew York | $151.48 | $63.05 |
| Rest of New YorkNew York | $124.39 | $53.32 |
| OhioOhio | $121.63 | $53.32 |
| OklahomaOklahoma | $118.94 | $52.13 |
| Portland, OROregon | $140.99 | $57.86 |
| Rest of OregonOregon | $128.97 | $54.45 |
| Metropolitan Philadelphia, PAPennsylvania | $135.42 | $57.54 |
| Rest of PennsylvaniaPennsylvania | $121.94 | $53.25 |
| Puerto RicoPuerto Rico | $131.31 | $55.67 |
| Rhode IslandRhode Island | $133.75 | $56.46 |
| South CarolinaSouth Carolina | $122.25 | $53.12 |
| South DakotaSouth Dakota | $128.27 | $53.45 |
| TennesseeTennessee | $119.81 | $51.80 |
| Austin, TXTexas | $135.75 | $56.59 |
| Beaumont, TXTexas | $121.09 | $53.01 |
| Brazoria, TXTexas | $128.93 | $54.78 |
| Dallas, TXTexas | $129.69 | $55.17 |
| Fort Worth, TXTexas | $128.73 | $54.96 |
| Galveston, TXTexas | $129.27 | $54.98 |
| Houston, TXTexas | $130.92 | $56.62 |
| Rest of TexasTexas | $124.90 | $53.89 |
| UtahUtah | $123.98 | $53.66 |
| VirginiaVirginia | $127.69 | $54.14 |
| Virgin Islands, VIUnited States Virgin Islands | $131.31 | $55.67 |
| VermontVermont | $127.78 | $53.71 |
| Rest of WashingtonWashington | $135.18 | $56.40 |
| King County, WAWashington | $153.69 | $61.89 |
| WisconsinWisconsin | $124.00 | $52.33 |
| West VirginiaWest Virginia | $118.52 | $53.50 |
| WyomingWyoming | $129.48 | $54.66 |
69424 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.
$114.77
$157.41
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $149.24 | 1 |
| AL | $116.52 | 1 |
| AR | $114.77 | 1 |
| AZ | $126.75 | 1 |
| CA | $138.90–$175.91 | 29 |
| CO | $136.31 | 1 |
| CT | $139.11 | 1 |
| DC | $149.82 | 1 |
| DE | $128.90 | 1 |
| FL | $127.40–$138.94 | 3 |
| GA | $120.09–$132.54 | 2 |
| GU | $142.63 | 1 |
| HI | $142.63 | 1 |
| IA | $119.99 | 1 |
| ID | $120.72 | 1 |
| IL | $123.30–$135.47 | 4 |
| IN | $121.45 | 1 |
| KS | $119.22 | 1 |
| KY | $118.96 | 1 |
| LA | $118.69–$124.80 | 2 |
| MA | $135.37–$150.38 | 2 |
| MD | $131.49–$149.82 | 3 |
| ME | $121.16–$128.26 | 2 |
| MI | $121.99–$128.84 | 2 |
| MN | $131.03 | 1 |
| MO | $116.45–$125.49 | 3 |
| MS | $115.64 | 1 |
| MT | $130.26 | 1 |
| NC | $122.51 | 1 |
| ND | $128.48 | 1 |
| NE | $120.73 | 1 |
| NH | $133.97 | 1 |
| NJ | $140.82–$148.14 | 2 |
| NM | $122.61 | 1 |
| NV | $129.86 | 1 |
| NY | $124.39–$153.43 | 5 |
| OH | $121.63 | 1 |
| OK | $118.94 | 1 |
| OR | $128.97–$140.99 | 2 |
| PA | $121.94–$135.42 | 2 |
| PR | $131.31 | 1 |
| RI | $133.75 | 1 |
| SC | $122.25 | 1 |
| SD | $128.27 | 1 |
| TN | $119.81 | 1 |
| TX | $121.09–$135.75 | 8 |
| UT | $123.98 | 1 |
| VA | $127.69–$149.82 | 2 |
| VI | $131.31 | 1 |
| VT | $127.78 | 1 |
| WA | $135.18–$153.69 | 2 |
| WI | $124.00 | 1 |
| WV | $118.52 | 1 |
| WY | $129.48 | 1 |
How the 69424 rate is calculated
Each of 69424’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 · 69424
RVUs × geographic indexes × conversion factor
Work0.83
0.83 RVUs× 1.000 GPCI
Practice expense2.98
2.98 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
3.9000
Conversion factor
$33.4009
Medicare rate
$130.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,604
- Code
- 69424
- Physician work
- 0.83
- Practice expense
- 2.98
- Malpractice
- 0.09
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 2.98 | × 0.915 | 2.7267 |
| Malpractice | 0.09 | × 0.397 | 0.0357 |
| Total RVUs | 3.5924 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$119.99
Office: (0.83 × 1 + 2.98 × 0.915 + 0.09 × 0.397) × $33.4009 = $119.99
Facility: (0.83 × 1 + 0.74 × 0.915 + 0.09 × 0.397) × $33.4009 = $51.53
Payment rules and modifiers for 69424
The CMS indicators that decide how 69424 is paid alongside other services.
CMS payment indicators · 69424
Tube removal, requires general anesthesia
| 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 | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69424 without 50 · national office
$130.26
Tube removal, requires general anesthesia
69424-50 · Bilateral: 150%
$195.39
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).
How 69424 has changed in Iowa
69424 · Office / nonfacility
$119.99
Effective 2026-10-01
The base rate is $6.85 higher than on 2025-10-01, moving from $113.14 to $119.99 (6.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$113.14changed to$119.99
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.85 changed to 0.83
- Practice expense RVU 2.85 changed to 2.98
- Malpractice RVU 0.10 changed to 0.09
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$117.65changed to$113.14
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.89 changed to 2.85
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$115.73changed to$117.65
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$120.04changed to$115.73
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.91 changed to 2.89
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$122.85changed to$120.04
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.93 changed to 2.91
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$123.07changed to$122.85
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.90 changed to 2.93
- Malpractice RVU 0.11 changed to 0.10
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$119.43changed to$123.07
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.66 changed to 2.90
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$119.41changed to$119.43
- Conversion factor 36.0391 changed to 36.0896
- Malpractice RVU 0.12 changed to 0.11
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$118.30changed to$119.41
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.63 changed to 2.66
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$117.94changed to$118.30
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.64 changed to 2.63
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$118.85changed to$117.94
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.69 changed to 2.64
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$119.10changed to$118.85
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.11 changed to 0.12
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$118.51changed to$119.10
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$118.43changed to$118.51
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.70 changed to 2.69
- Malpractice RVU 0.10 changed to 0.11
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$121.91changed to$118.43
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.03 changed to 2.70
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $121.91
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $119.99 | $51.53 | RVU26D |
| 2026-07-01 | $119.99 | $51.53 | RVU26C |
| 2026-04-01 | $119.99 | $51.53 | RVU26B |
| 2026-01-01 | $119.99 | $51.53 | RVU26A |
| 2025-10-01 | $113.14 | $55.55 | RVU25D |
| 2025-07-01 | $113.14 | $55.55 | RVU25C |
| 2025-04-01 | $113.14 | $55.55 | RVU25B |
| 2025-01-01 | $113.14 | $55.55 | RVU25A |
| 2024-10-01 | $117.65 | $56.26 | RVU24D |
| 2024-07-01 | $117.65 | $56.26 | RVU24C |
| 2024-04-01 | $117.65 | $56.26 | RVU24B |
| 2024-03-09 | $117.65 | $56.26 | RVU24AR |
| 2024-01-01 | $115.73 | $55.34 | RVU24A |
| 2023-10-01 | $120.04 | $56.51 | RVU23D |
| 2023-07-01 | $120.04 | $56.51 | RVU23C |
| 2023-04-01 | $120.04 | $56.51 | RVU23B |
| 2023-01-01 | $120.04 | $56.51 | RVU23A |
| 2022-10-01 | $122.85 | $56.62 | RVU22D |
| 2022-07-01 | $122.85 | $56.62 | RVU22C |
| 2022-04-01 | $122.85 | $56.62 | RVU22B |
| 2022-01-01 | $122.85 | $56.62 | RVU22A |
| 2021-10-01 | $123.07 | $56.61 | RVU21D |
| 2021-07-01 | $123.07 | $56.61 | RVU21C |
| 2021-04-01 | $123.07 | $56.61 | RVU21B |
| 2021-01-01 | $123.07 | $56.61 | RVU21A |
| 2020-10-01 | $119.43 | $57.56 | RVU20D |
| 2020-07-01 | $119.43 | $57.56 | RVU20C |
| 2020-04-01 | $119.43 | $57.56 | RVU20B |
| 2020-01-01 | $119.43 | $57.56 | RVU20A |
| 2019-10-01 | $119.41 | $57.96 | RVU19D |
| 2019-07-01 | $119.41 | $57.96 | RVU19C |
| 2019-04-01 | $119.41 | $57.96 | RVU19B |
| 2019-01-01 | $119.41 | $57.96 | RVU19A |
| 2018-10-01 | $118.30 | $57.90 | RVU18D |
| 2018-07-01 | $118.30 | $57.90 | RVU18C |
| 2018-04-01 | $118.30 | $57.90 | RVU18B |
| 2018-01-01 | $118.30 | $57.90 | RVU18AR1 |
| 2017-10-01 | $117.94 | $58.70 | RVU17D |
| 2017-07-01 | $117.94 | $58.70 | RVU17C |
| 2017-04-01 | $117.94 | $58.70 | RVU17B |
| 2017-01-01 | $117.94 | $58.70 | RVU17A |
| 2016-10-01 | $118.85 | $59.18 | RVU16D |
| 2016-07-01 | $118.85 | $59.18 | RVU16C |
| 2016-04-01 | $118.85 | $59.18 | RVU16B |
| 2016-01-01 | $118.85 | $59.18 | RVU16A |
| 2015-10-01 | $119.10 | $58.89 | RVU15D |
| 2015-07-01 | $119.10 | $58.89 | RVU15C |
| 2015-04-01 | $118.51 | $58.60 | RVU15B |
| 2015-01-01 | $118.51 | $58.60 | RVU15A |
| 2014-10-01 | $118.43 | $58.99 | RVU14D |
| 2014-07-01 | $118.43 | $58.99 | RVU14C |
| 2014-04-01 | $118.43 | $58.99 | RVU14B |
| 2014-01-01 | $118.43 | $58.99 | RVU14A |
| 2013-10-01 | $121.91 | $58.54 | RVU13D |
| 2013-07-01 | $121.91 | $58.54 | RVU13C |
| 2013-04-01 | $121.91 | $58.54 | RVU13B |
| 2013-01-01 | $121.91 | $58.54 | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
69424 billing questions
When is 69424 appropriate instead of an insertion code?
Use 69424 for removing an existing ventilating tube when general anesthesia is required. Tube placement codes describe inserting a new tube, not removing one.
Does the code include same-day follow-up care?
Yes. The zero-day global period includes same-day preoperative and postoperative care.
How is bilateral removal reported?
For removal from both ears, report modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 69424. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 69424?
Document the ear treated, the tube removed, the reason for removal, and why general anesthesia was required.
What happens when other procedures are performed in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% under 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
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