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CPT code 69433: Ear tube placement, local or topical anesthesia2026 Medicare rate & RVUs in Houston, TX

Report this service when a clinician creates an eardrum opening and places a ventilating tube using local or topical anesthesia.

CMS RVU26DEffective Oct 1, 2026One payment locality36.2K Medicare services in 2024

In Houston, TX, Medicare pays $204.45 for 69433 in the office and $122.19 when it’s performed in a hospital or facility.

$204.45Office (non-facility)
$122.19Hospital or facility
+1.0%vs the national office rate ($202.41)

Check a contract rate as a % of Medicare · 69433 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 69433 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 69433 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 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.

How Houston, TX compares for 69433

Across 109 of 109 payment localities, the office rate for 69433 runs from $178.66 in Arkansas to $268.55 in San Benito County, CA. Houston, TX pays $204.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

69433 in Houston, TX vs other payment areas
  1. Houston, TX · this page$204.45
  2. Austin, TX · Texas$210.08+$5.63
  3. Beaumont, TX · Texas$188.93−$15.52
  4. Brazoria, TX · Texas$199.98−$4.47
  5. Dallas, TX · Texas$201.30−$3.15
  6. Fort Worth, TX · Texas$199.94−$4.51
  7. Galveston, TX · Texas$200.60−$3.85

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

Every other payment area

69433 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$194.37$115.76
Los Angeles, CACalifornia$228.55$130.56
Washington, DC areaDistrict of Columbia$231.65$134.07
Miami, FLFlorida$219.05$132.82
Chicago, ILIllinois$212.57$129.32
Manhattan, NYNew York$233.17$136.91
AlaskaAlaska$234.19$145.97
AlabamaAlabama$181.33$108.85

69433 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$178.66

$241.22

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

View every state and territory as a table
69433 office rate range by state
State / territoryOffice rate rangeLocalities
AK$234.191
AL$181.331
AR$178.661
AZ$196.931
CA$213.88–$268.5529
CO$210.721
CT$216.011
DC$231.651
DE$200.231
FL$199.59–$219.053
GA$188.17–$206.282
GU$219.221
HI$219.221
IA$185.921
ID$187.171
IL$193.81–$212.574
IN$188.271
KS$185.081
KY$185.801
LA$185.52–$194.852
MA$209.45–$231.732
MD$204.08–$231.653
ME$188.21–$198.522
MI$190.76–$202.172
MN$201.661
MO$182.31–$195.503
MS$180.521
MT$202.401
NC$190.211
ND$198.241
NE$186.941
NH$207.451
NJ$218.41–$229.192
NM$191.841
NV$201.381
NY$193.11–$238.965
OH$189.911
OK$185.411
OR$199.75–$217.452
PA$190.19–$210.602
PR$203.891
RI$207.381
SC$190.391
SD$197.751
TN$186.031
TX$188.93–$210.088
UT$193.041
VA$197.89–$231.652
VI$203.891
VT$197.501
WA$209.04–$236.442
WI$191.501
WV$186.531
WY$200.591

See 69433 in every payment locality

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

Office or facility?

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.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,605

Code
69433
Physician work
1.53
Practice expense
4.32
Malpractice
0.21

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 69433 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.53× 1.0081.5422
Practice expense4.32× 0.9934.2898
Malpractice0.21× 1.3760.2890
Total RVUs6.1210
Conversion factor× 33.4009

Office rate, Houston, TX$204.45

Office: (1.53 × 1.008 + 4.32 × 0.993 + 0.21 × 1.376) × $33.4009 = $204.45

Facility: (1.53 × 1.008 + 1.84 × 0.993 + 0.21 × 1.376) × $33.4009 = $122.19

Open 69433 in the RVU calculator

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

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 · 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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

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).

When to use modifier 50

Codes related to 69433

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

Codes related to 69433
CodeHow it relatesOffice range, Houston, TX
Used instead
69420Eardrum incision, no ventilating tubeEardrum incision without ventilating-tube placement.$193.61
69421Myringotomy, general anesthesia, no tubeEardrum incision without tube placement under general anesthesia.No office rate
Same family
69436Tympanostomy, tube insertion, general anesthesiaTube-placement sibling for the general-anesthesia approach.No office rate

How 69433 has changed in Houston, TX

69433 · Office / nonfacility

$204.45

Effective 2026-10-01

The base rate is $5.04 higher than on 2025-10-01, moving from $199.41 to $204.45 (2.5%).

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

    $199.41changed to$204.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.57 changed to 1.53
    • Practice expense RVU 4.25 changed to 4.32
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $207.68changed to$199.41

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.31 changed to 4.25
    • Malpractice RVU 0.23 changed to 0.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $204.29changed to$207.68

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $211.76changed to$204.29

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.32 changed to 4.31
    • Malpractice RVU 0.22 changed to 0.23
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $214.26changed to$211.76

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.25 changed to 4.32
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $212.14changed to$214.26

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.15 changed to 4.25
    • Malpractice RVU 0.21 changed to 0.22

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $206.41changed to$212.14

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.83 changed to 4.15
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $206.62changed to$206.41

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.87 changed to 3.83
    • Malpractice RVU 0.23 changed to 0.22
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $207.12changed to$206.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.89 changed to 3.87

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $207.95changed to$207.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.94 changed to 3.89
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $209.58changed to$207.95

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.01 changed to 3.94
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $209.25changed to$209.58

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.98 changed to 4.01

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $208.21changed to$209.25

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $209.40changed to$208.21

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.04 changed to 3.98
    • Malpractice RVU 0.21 changed to 0.23
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $214.22changed to$209.40

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.50 changed to 4.04
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $214.22

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$204.45$122.19RVU26D
2026-07-01$204.45$122.19RVU26C
2026-04-01$204.45$122.19RVU26B
2026-01-01$204.45$122.19RVU26A
2025-10-01$199.41$134.20RVU25D
2025-07-01$199.41$134.20RVU25C
2025-04-01$199.41$134.20RVU25B
2025-01-01$199.41$134.20RVU25A
2024-10-01$207.68$137.90RVU24D
2024-07-01$207.68$137.90RVU24C
2024-04-01$207.68$137.90RVU24B
2024-03-09$207.68$137.90RVU24AR
2024-01-01$204.29$135.65RVU24A
2023-10-01$211.76$138.43RVU23D
2023-07-01$211.76$138.43RVU23C
2023-04-01$211.76$138.43RVU23B
2023-01-01$211.76$138.43RVU23A
2022-10-01$214.26$137.70RVU22D
2022-07-01$214.26$137.70RVU22C
2022-04-01$214.26$137.70RVU22B
2022-01-01$214.26$137.70RVU22A
2021-10-01$212.14$136.02RVU21D
2021-07-01$212.14$136.02RVU21C
2021-04-01$212.14$136.02RVU21B
2021-01-01$212.14$136.02RVU21A
2020-10-01$206.41$136.47RVU20D
2020-07-01$206.41$136.47RVU20C
2020-04-01$206.41$136.47RVU20B
2020-01-01$206.41$136.47RVU20A
2019-10-01$206.62$136.59RVU19D
2019-07-01$206.62$136.59RVU19C
2019-04-01$206.62$136.59RVU19B
2019-01-01$206.62$136.59RVU19A
2018-10-01$207.12$136.08RVU18D
2018-07-01$207.12$136.08RVU18C
2018-04-01$207.12$136.08RVU18B
2018-01-01$207.12$136.08RVU18AR1
2017-10-01$207.95$136.98RVU17D
2017-07-01$207.95$136.98RVU17C
2017-04-01$207.95$136.98RVU17B
2017-01-01$207.95$136.98RVU17A
2016-10-01$209.58$138.26RVU16D
2016-07-01$209.58$138.26RVU16C
2016-04-01$209.58$138.26RVU16B
2016-01-01$209.58$138.26RVU16A
2015-10-01$209.25$138.04RVU15D
2015-07-01$209.25$138.04RVU15C
2015-04-01$208.21$137.35RVU15B
2015-01-01$208.21$137.35RVU15A
2014-10-01$209.40$137.82RVU14D
2014-07-01$209.40$137.82RVU14C
2014-04-01$209.40$137.82RVU14B
2014-01-01$209.40$137.82RVU14A
2013-10-01$214.22$137.85RVU13D
2013-07-01$214.22$137.85RVU13C
2013-04-01$214.22$137.85RVU13B
2013-01-01$214.22$137.85RVU13AR

Price 69433 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for 69433PPRRVU2026_Oct_nonQPP.csv, line 7,605 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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