CPT code 69145: Ear canal excision2026 Medicare rate & RVUs

Medicare pays $404.82 for 69145 nationally in the office and $237.15 in a hospital or facility. Local office rates run $355.64–$542.78.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 69145 covers

This service removes a lesion from the external auditory canal rather than sampling it solely for diagnosis. An otolaryngologist typically performs the excision in an operating room or, when clinically appropriate, another procedural setting. The operative record should identify the lesion’s canal location and describe its extent, the tissues removed, and any tympanic membrane involvement. A lesion such as a canal mass may require excision when removal, rather than biopsy alone, is the planned treatment.

Select this code for the documented canal lesion excision; use a simple-excision or extensive-excision sibling when the operative service matches that distinct level. The record should support the scope of surgery and whether the tympanic membrane was involved. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. 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 69145 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

69145 rates by state

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

How the 69145 rate is calculated

Each of 69145’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.

Payment rules and modifiers for 69145

69145 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

69145 compared with similar codes

How to choose

69140Ear canal excision

69140 is the simple-excision option. This code represents a different canal lesion excision level; the operative note should support the service performed and any tympanic membrane involvement.

69150Ear canal surgery

69150 is the extensive-excision sibling. Select between the codes according to the documented scope of canal surgery.

69105Ear canal biopsy

69105 is for a diagnostic biopsy of the external auditory canal. Report 69145 when the service is excision of the lesion rather than tissue sampling alone.

Codes related to 69145

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

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

Open CMS sourceHow we calculate rates