Billing code 69105: Ear canal biopsyMedicare rate & RVUs
Reports tissue sampling of a suspicious lesion in the external auditory canal when microscopic examination is needed to establish a diagnosis.
Medicare pays $143.96 for 69105 nationally in the office and $57.45 in a hospital or facility. Local office rates run $126.30–$195.05.
Medicare rate · 69105
Ear canal biopsy
Swap in your local Medicare rate.
- Work RVUs
- 0.83
- Total RVUs
- 4.31
- Global days
- 000
National rate · 2026
$143.96
Office setting, before claim adjustments.
See every locality for 69105 → · Billed by an NP, PA or therapist? →
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 10 sections
What 69105 covers
An otolaryngologist typically performs this biopsy when tissue from a lesion in the external auditory canal is needed for diagnosis, such as evaluation of a growth or abnormal area in the ear canal. The canal extends inward from the ear opening toward the tympanic membrane; a biopsy of the visible outer ear instead is a different service. The procedure may be performed in an office or facility, depending on the lesion and clinical circumstances.
Choose this code when the service is tissue sampling for diagnosis, rather than definitive removal of the canal lesion. Document the canal site, the abnormal finding, the reason for sampling, and the specimen obtained. A separately performed pathology interpretation may be reported by the responsible pathologist. This is a 0-day global procedure, so same-day preoperative and postoperative care is included. For bilateral reporting with modifier 50, CMS pays 150%. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted; 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 69105 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$126.30 to $195.05
109 of 109 payment localities
69105 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.
$126.30
$174.29
Color shows the midpoint of each state’s locality range.
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| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $163.49 | 1 |
| AL | $128.29 | 1 |
| AR | $126.30 | 1 |
| AZ | $139.94 | 1 |
| CA | $153.53–$195.05 | 29 |
| CO | $150.69 | 1 |
| CT | $153.95 | 1 |
| DC | $165.91 | 1 |
| DE | $142.37 | 1 |
| FL | $140.85–$154.19 | 3 |
| GA | $132.51–$146.58 | 2 |
| GU | $157.83 | 1 |
| HI | $157.83 | 1 |
| IA | $132.17 | 1 |
| ID | $133.02 | 1 |
| IL | $136.23–$150.03 | 4 |
| IN | $133.85 | 1 |
| KS | $131.33 | 1 |
| KY | $131.15 | 1 |
| LA | $130.86–$137.82 | 2 |
| MA | $149.62–$166.53 | 2 |
| MD | $145.28–$165.91 | 3 |
| ME | $133.56–$141.59 | 2 |
| MI | $134.64–$142.54 | 2 |
| MN | $144.64 | 1 |
| MO | $128.33–$138.56 | 3 |
| MS | $127.35 | 1 |
| MT | $143.95 | 1 |
| NC | $135.09 | 1 |
| ND | $141.78 | 1 |
| NE | $133.01 | 1 |
| NH | $148.11 | 1 |
| NJ | $155.78–$163.96 | 2 |
| NM | $135.35 | 1 |
| NV | $143.46 | 1 |
| NY | $137.24–$170.15 | 5 |
| OH | $134.19 | 1 |
| OK | $131.09 | 1 |
| OR | $142.42–$155.96 | 2 |
| PA | $134.53–$149.78 | 2 |
| PR | $145.14 | 1 |
| RI | $147.80 | 1 |
| SC | $134.85 | 1 |
| SD | $141.52 | 1 |
| TN | $132.01 | 1 |
| TX | $133.57–$150.12 | 8 |
| UT | $136.83 | 1 |
| VA | $140.96–$165.91 | 2 |
| VI | $145.14 | 1 |
| VT | $141.02 | 1 |
| WA | $149.41–$170.22 | 2 |
| WI | $136.69 | 1 |
| WV | $130.80 | 1 |
| WY | $143.00 | 1 |
How the 69105 rate is calculated
Each of 69105’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 · 69105
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.83Practice expense 3.37Malpractice 0.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69105
The CMS indicators that decide how 69105 is paid alongside other services.
CMS payment indicators · 69105
Ear canal biopsy
| 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
69105 without 50 · national office
$143.96
Ear canal biopsy
69105-50 · Bilateral: 150%
$215.94
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).
69105 compared with similar codes
Compare codes
69105 vs 69100 vs 69140 vs 69145: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69100Ear biopsy
- Choose 69105 for tissue sampled from inside the external auditory canal; choose 69100 for a biopsy of the external ear, such as the pinna.
- 69140Ear canal excision
- 69105 represents diagnostic tissue sampling. Consider 69140 when the service is excision of an external auditory canal lesion.
- 69145Ear canal excision
- 69105 is for biopsy sampling in the canal; 69145 is an excision code for removal of a canal lesion.
69105 billing questions
How is this different from 69100?
This code is for a biopsy in the external auditory canal. Code 69100 is for a biopsy of the external ear, such as the pinna.
When should an excision code be considered instead?
Use a canal lesion excision code when the service is removal rather than diagnostic tissue sampling. Codes 69140 and 69145 are the nearby canal-lesion excision choices.
Is the pathology examination included?
This code describes obtaining the tissue specimen. A separately performed pathology interpretation may be reported by the responsible pathologist.
How is bilateral biopsy paid?
For a bilateral procedure reported with modifier 50, CMS pays 150% under the stated bilateral rule.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others are paid at 50%. Same-day preoperative and postoperative care for this biopsy is included in its 0-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted for this code. 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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