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CPT code 69540: Aural polyp, surgical excision2026 Medicare rate & RVUs in Metropolitan Boston, MA

Reports surgical removal of an aural polyp, commonly encountered with chronic ear disease, rather than diagnostic sampling or treatment of another ear lesion.

CMS RVU26DEffective Oct 1, 2026One payment locality379 Medicare services in 2024

In Metropolitan Boston, MA, Medicare pays $242.79 for 69540 in the office and $135.51 when it’s performed in a hospital or facility.

$242.79Office (non-facility)
$135.51Hospital or facility
+15.6%vs the national office rate ($210.09)

Check a contract rate as a % of Medicare · 69540 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 69540 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Metropolitan Boston, MA
  2. What 69540 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 69540 covers

CPT 69540 represents surgical removal of an aural polyp, often tissue protruding into the ear canal in the setting of chronic middle-ear inflammation or infection. An otolaryngologist, frequently an otologist, removes the polyp under direct visualization in an office or facility setting. The code describes excision of the polyp, not simply examination or diagnostic sampling of an ear lesion.

Document the affected ear, the polyp and its site, the removal performed, and relevant underlying ear disease; distinguish excision from biopsy. Medicare assigns a 10-day global period, including related postoperative visits during that period. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery services are not paid under the statutory restriction; 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 Metropolitan Boston, MA compares for 69540

Across 109 of 109 payment localities, the office rate for 69540 runs from $184.15 in Arkansas to $283.98 in San Benito County, CA. Metropolitan Boston, MA pays $242.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

69540 in Metropolitan Boston, MA vs other payment areas
  1. Metropolitan Boston, MA · this page$242.79
  2. Rest of Massachusetts · Massachusetts$218.18−$24.61
  3. Los Angeles, CA · California$239.63−$3.16
  4. Washington, DC area · District of Columbia$242.04−$0.75
  5. Miami, FL · Florida$225.98−$16.81
  6. Chicago, IL · Illinois$218.98−$23.81
  7. Manhattan, NY · New York$242.68−$0.11

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

Every other payment area

69540 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$238.38$142.69
AlabamaAlabama$187.07$108.45
ArkansasArkansas$184.15$106.97
ArizonaArizona$204.16$117.10
Bakersfield, CACalifornia$224.19$125.72
Chico, CACalifornia$223.67$125.20
El Centro, CACalifornia$223.70$125.23
Fresno, CACalifornia$223.67$125.20

69540 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.

$184.15

$253.83

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

View every state and territory as a table
69540 office rate range by state
State / territoryOffice rate rangeLocalities
AK$238.381
AL$187.071
AR$184.151
AZ$204.161
CA$223.67–$283.9829
CO$219.721
CT$224.751
DC$242.041
DE$207.731
FL$205.93–$225.983
GA$193.61–$214.042
GU$229.941
HI$229.941
IA$192.581
ID$193.861
IL$199.27–$219.434
IN$195.081
KS$191.431
KY$191.451
LA$191.06–$201.272
MA$218.18–$242.792
MD$211.97–$242.043
ME$194.75–$206.402
MI$196.66–$208.502
MN$210.601
MO$187.40–$202.263
MS$185.821
MT$210.081
NC$196.981
ND$206.521
NE$193.781
NH$216.041
NJ$227.33–$239.202
NM$197.741
NV$209.251
NY$200.14–$248.725
OH$195.931
OK$191.271
OR$207.65–$227.332
PA$196.37–$218.682
PR$211.801
RI$215.611
SC$196.781
SD$206.101
TN$192.441
TX$194.97–$218.968
UT$199.681
VA$205.55–$242.042
VI$211.801
VT$205.491
WA$217.84–$248.102
WI$199.071
WV$191.291
WY$208.531

See 69540 in every payment locality

How the 69540 rate is calculated

Each of 69540’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 · 69540

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.22

1.22 RVUs× 1.000 GPCI

Practice expense4.89

4.89 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

6.2900

Conversion factor

$33.4009

Medicare rate

$210.09

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

The exact Metropolitan Boston, MA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,615

Code
69540
Physician work
1.22
Practice expense
4.89
Malpractice
0.18

GPCI2026.csv

62

Locality
Metropolitan Boston, MA
Physician work
1.041
Practice expense
1.194
Malpractice
0.890
Office calculation for 69540 in Metropolitan Boston, MA
ComponentRVULocality factorAdjusted
Physician work1.22× 1.0411.2700
Practice expense4.89× 1.1945.8387
Malpractice0.18× 0.8900.1602
Total RVUs7.2689
Conversion factor× 33.4009

Office rate, Metropolitan Boston, MA$242.79

Office: (1.22 × 1.041 + 4.89 × 1.194 + 0.18 × 0.89) × $33.4009 = $242.79

Facility: (1.22 × 1.041 + 2.2 × 1.194 + 0.18 × 0.89) × $33.4009 = $135.51

Open 69540 in the RVU calculator

Payment rules and modifiers for 69540

69540 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69540

Aural polyp, surgical excision

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 · 69540

Aural polyp, surgical excision

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

69540 without 50 · national office

$210.09

Aural polyp, surgical excision

69540-50 · Bilateral: 150%

$315.14

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 69540

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

Codes related to 69540
CodeHow it relatesOffice range, Metropolitan Boston, MA
Used instead
69105Ear canal biopsy, external auditory canalFor diagnostic sampling of an external auditory canal lesion rather than excision of an aural polyp.$166.53
69145Ear canal excision, with or without tympanic membraneFor excision of a documented external auditory canal soft-tissue lesion that is not an aural polyp.$465.95
69110Auricular excision, partial auricleFor excision of a lesion on the external ear, rather than an aural polyp.$537.67

How 69540 has changed in Metropolitan Boston, MA

69540 · Office / nonfacility

$242.79

Effective 2026-10-01

The base rate is $9.22 higher than on 2025-10-01, moving from $233.57 to $242.79 (3.9%).

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

    $233.57changed to$242.79

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.25 changed to 1.22
    • Practice expense RVU 4.81 changed to 4.89
    • Work GPCI 1.042 changed to 1.041
    • Practice expense GPCI 1.197 changed to 1.194
    • Malpractice GPCI 0.894 changed to 0.890

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $245.85changed to$233.57

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.94 changed to 4.81
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $241.83changed to$245.85

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $252.36changed to$241.83

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.98 changed to 4.94
    • Work GPCI 1.045 changed to 1.042
    • Practice expense GPCI 1.200 changed to 1.197
    • Malpractice GPCI 0.868 changed to 0.894

  5. January 1, 2023

    RVU23A

    $256.57changed to$252.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.94 changed to 4.98
    • Work GPCI 1.049 changed to 1.045
    • Practice expense GPCI 1.203 changed to 1.200
    • Malpractice GPCI 0.842 changed to 0.868

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $253.07changed to$256.57

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.82 changed to 4.94
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $242.27changed to$253.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.40 changed to 4.82
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.041 changed to 1.049
    • Practice expense GPCI 1.191 changed to 1.203
    • Malpractice GPCI 0.952 changed to 0.842

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $242.07changed to$242.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.44 changed to 4.40
    • Work GPCI 1.033 changed to 1.041
    • Practice expense GPCI 1.179 changed to 1.191
    • Malpractice GPCI 1.061 changed to 0.952

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $241.34changed to$242.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.42 changed to 4.44
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $240.10changed to$241.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.49 changed to 4.42
    • Malpractice RVU 0.18 changed to 0.19
    • Work GPCI 1.025 changed to 1.033
    • Practice expense GPCI 1.171 changed to 1.179
    • Malpractice GPCI 0.839 changed to 1.061

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $239.79changed to$240.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.57 changed to 4.49
    • Work GPCI 1.017 changed to 1.025
    • Practice expense GPCI 1.163 changed to 1.171
    • Malpractice GPCI 0.617 changed to 0.839

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $238.57changed to$239.79

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.52 changed to 4.57

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $237.38changed to$238.57

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $239.36changed to$237.38

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.59 changed to 4.52
    • Malpractice RVU 0.15 changed to 0.18
    • Work GPCI 1.016 changed to 1.017
    • Practice expense GPCI 1.156 changed to 1.163
    • Malpractice GPCI 0.704 changed to 0.617

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$239.36

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$242.79$135.51RVU26D
2026-07-01$242.79$135.51RVU26C
2026-04-01$242.79$135.51RVU26B
2026-01-01$242.79$135.51RVU26A
2025-10-01$233.57$143.36RVU25D
2025-07-01$233.57$143.36RVU25C
2025-04-01$233.57$143.36RVU25B
2025-01-01$233.57$143.36RVU25A
2024-10-01$245.85$149.02RVU24D
2024-07-01$245.85$149.02RVU24C
2024-04-01$245.85$149.02RVU24B
2024-03-09$245.85$149.02RVU24AR
2024-01-01$241.83$146.59RVU24A
2023-10-01$252.36$151.52RVU23D
2023-07-01$252.36$151.52RVU23C
2023-04-01$252.36$151.52RVU23B
2023-01-01$252.36$151.52RVU23A
2022-10-01$256.57$152.08RVU22D
2022-07-01$256.57$152.08RVU22C
2022-04-01$256.57$152.08RVU22B
2022-01-01$256.57$152.08RVU22A
2021-10-01$253.07$148.55RVU21D
2021-07-01$253.07$148.55RVU21C
2021-04-01$253.07$148.55RVU21B
2021-01-01$253.07$148.55RVU21A
2020-10-01$242.27$145.56RVU20D
2020-07-01$242.27$145.56RVU20C
2020-04-01$242.27$145.56RVU20B
2020-01-01$242.27$145.56RVU20A
2019-10-01$242.07$145.20RVU19D
2019-07-01$242.07$145.20RVU19C
2019-04-01$242.07$145.20RVU19B
2019-01-01$242.07$145.20RVU19A
2018-10-01$241.34$145.00RVU18D
2018-07-01$241.34$145.00RVU18C
2018-04-01$241.34$145.00RVU18B
2018-01-01$241.34$145.00RVU18AR1
2017-10-01$240.10$143.44RVU17D
2017-07-01$240.10$143.44RVU17C
2017-04-01$240.10$143.44RVU17B
2017-01-01$240.10$143.44RVU17A
2016-10-01$239.79$142.77RVU16D
2016-07-01$239.79$142.77RVU16C
2016-04-01$239.79$142.77RVU16B
2016-01-01$239.79$142.77RVU16A
2015-10-01$238.57$142.45RVU15D
2015-07-01$238.57$142.45RVU15C
2015-04-01$237.38$141.74RVU15B
2015-01-01$237.38$141.74RVU15A
2014-10-01$239.36$142.45RVU14D
2014-07-01$239.36$142.45RVU14C
2014-04-01$239.36$142.45RVU14B
2014-01-01$239.36$142.45RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 69540 for an earlier date of service

Where the Metropolitan Boston, MA rate applies

Metropolitan Boston, MA is a Medicare payment area, not a city. Our Census mapping connects it to 60 cities and communities in Massachusetts. Some span more than one payment area; confirm with the service ZIP.

  • Boston
  • Arlington
  • Ayer
  • Bellingham
  • Belmont
  • Braintree Town
  • Brookline
  • Burlington

Browse all communities in Massachusetts

69540 billing questions

How is 69540 distinguished from a biopsy of an ear-canal lesion?

Use 69540 when the documented service is excision of an aural polyp. When tissue is sampled for diagnosis rather than excised as a polyp, consider 69105.

Is an aural polyp the same as any external auditory canal soft-tissue lesion?

No. 69540 identifies an aural polyp; 69145 is for excision of a documented external auditory canal soft-tissue lesion that is not characterized as an aural polyp.

How should bilateral excision be reported?

For excision performed on both sides, report modifier 50. CMS pays bilateral procedures at 150%.

What postoperative care is included?

Related postoperative visits during the 10-day global period are included in the procedure.

How does the multiple-procedure rule affect 69540?

When it is the highest-valued procedure in the same session, it is paid in full; other procedures are paid at 50%. If another procedure is highest-valued, 69540 is among the other procedures.

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 69540PPRRVU2026_Oct_nonQPP.csv, line 7,615 (RVU26D)
Geographic factors for Metropolitan Boston, MAGPCI2026.csv, line 62 (RVU26D)

Open CMS sourceHow we calculate rates

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