CPT code 69433: Ear tube placement, local or topical anesthesia2026 Medicare rate & RVUs in Florida
Report this service when a clinician creates an eardrum opening and places a ventilating tube using local or topical anesthesia.
Medicare pays $199.59–$219.05 for 69433 in the office in Florida, from Rest of Florida to Miami, FL. 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 69433 covers
An otolaryngologist typically performs this procedure in an office or other setting using local or topical anesthesia. The clinician makes an opening in the tympanic membrane and inserts a ventilating tube to help maintain middle-ear ventilation, commonly for persistent middle-ear fluid or recurrent ear infections. The tube placement is part of the service; an incision without tube insertion is a different service.
Report the code for each treated ear and document the clinical indication, side, anesthetic approach, eardrum opening, and tube placement. CMS assigns a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced under the standard multiple-procedure rule. For bilateral performance, 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.
Where 69433 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$199.59 to $219.05
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | $209.95 | $126.04 |
| Miami, FL | $219.05 | $132.82 |
| Rest of Florida | $199.59 | $120.40 |
How the 69433 rate is calculated
Each of 69433’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 · 69433
RVUs × geographic indexes × conversion factor
Work1.53
1.53 RVUs× 1.000 GPCI
Practice expense4.32
4.32 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
6.0600
Conversion factor
$33.4009
Medicare rate
$202.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69433
69433 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69433
Ear tube placement, local or topical anesthesia
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69433
Ear tube placement, local or topical anesthesia
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.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69433 without 50 · national office
$202.41
Ear tube placement, local or topical anesthesia
69433-50 · Bilateral: 150%
$303.62
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).
69433 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 69420Eardrum incisionNo ventilating tube
- Choose 69433 when a ventilating tube is inserted under local or topical anesthesia. Code 69420 is for an eardrum incision without tube placement.
- 69421MyringotomyGeneral anesthesia, no tube
- Both involve an eardrum incision without tube placement; 69421 is the general-anesthesia option, while 69433 includes tube insertion under local or topical anesthesia.
- 69436TympanostomyTube insertion, general anesthesia
- Use 69436 when the tube-placement procedure is performed under general anesthesia. Code 69433 is for local or topical anesthesia.
- 69424Tube removalRequires general anesthesia
- Code 69424 describes removal of a ventilating tube, rather than creating an eardrum opening and inserting one.
69433 billing questions
When should 69433 be chosen instead of 69420?
Use 69433 when a ventilating tube is placed through the eardrum opening under local or topical anesthesia. Code 69420 describes an incision without tube placement.
How does 69433 differ from 69436?
Both involve eardrum opening and tube placement. The distinction is the anesthetic approach: 69433 is for local or topical anesthesia, while 69436 is for general anesthesia.
Can both ears be reported?
Yes. For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 69433. Co-surgeons and team surgery are not permitted.
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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