Billing code 69424: Tube removalMedicare rate & RVUs
Reports removal of a tympanostomy tube when the procedure requires general anesthesia, such as removal of a retained tube in an operating room.
Medicare pays $130.26 for 69424 nationally in the office and $55.45 in a hospital or facility. Local office rates run $114.77–$175.91.
Medicare rate · 69424
Tube removal
Swap in your local Medicare rate.
- Work RVUs
- 0.83
- Total RVUs
- 3.90
- Global days
- 000
National rate · 2026
$130.26
Office setting, before claim adjustments.
See every locality for 69424 → · 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 69424 covers
This service covers removal of a ventilating tube from the tympanic membrane when general anesthesia is required. An otolaryngologist typically performs it in an operating room, often for a retained tube or when a child cannot tolerate removal while awake. The operative record should identify the ear, the tube removed, and the clinical reason for removal, and should support the need for general anesthesia.
Report the service for the tube removal itself, not for making an opening in the eardrum or placing a new tube. The CMS global period is zero days, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral removal, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 69424 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
$114.77 to $175.91
109 of 109 payment localities
69424 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.
$114.77
$157.41
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $149.24 | 1 |
| AL | $116.52 | 1 |
| AR | $114.77 | 1 |
| AZ | $126.75 | 1 |
| CA | $138.90–$175.91 | 29 |
| CO | $136.31 | 1 |
| CT | $139.11 | 1 |
| DC | $149.82 | 1 |
| DE | $128.90 | 1 |
| FL | $127.40–$138.94 | 3 |
| GA | $120.09–$132.54 | 2 |
| GU | $142.63 | 1 |
| HI | $142.63 | 1 |
| IA | $119.99 | 1 |
| ID | $120.72 | 1 |
| IL | $123.30–$135.47 | 4 |
| IN | $121.45 | 1 |
| KS | $119.22 | 1 |
| KY | $118.96 | 1 |
| LA | $118.69–$124.80 | 2 |
| MA | $135.37–$150.38 | 2 |
| MD | $131.49–$149.82 | 3 |
| ME | $121.16–$128.26 | 2 |
| MI | $121.99–$128.84 | 2 |
| MN | $131.03 | 1 |
| MO | $116.45–$125.49 | 3 |
| MS | $115.64 | 1 |
| MT | $130.26 | 1 |
| NC | $122.51 | 1 |
| ND | $128.48 | 1 |
| NE | $120.73 | 1 |
| NH | $133.97 | 1 |
| NJ | $140.82–$148.14 | 2 |
| NM | $122.61 | 1 |
| NV | $129.86 | 1 |
| NY | $124.39–$153.43 | 5 |
| OH | $121.63 | 1 |
| OK | $118.94 | 1 |
| OR | $128.97–$140.99 | 2 |
| PA | $121.94–$135.42 | 2 |
| PR | $131.31 | 1 |
| RI | $133.75 | 1 |
| SC | $122.25 | 1 |
| SD | $128.27 | 1 |
| TN | $119.81 | 1 |
| TX | $121.09–$135.75 | 8 |
| UT | $123.98 | 1 |
| VA | $127.69–$149.82 | 2 |
| VI | $131.31 | 1 |
| VT | $127.78 | 1 |
| WA | $135.18–$153.69 | 2 |
| WI | $124.00 | 1 |
| WV | $118.52 | 1 |
| WY | $129.48 | 1 |
How the 69424 rate is calculated
Each of 69424’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 · 69424
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.83Practice expense 2.98Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69424
The CMS indicators that decide how 69424 is paid alongside other services.
CMS payment indicators · 69424
Tube removal
| 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
69424 without 50 · national office
$130.26
Tube removal
69424-50 · Bilateral: 150%
$195.39
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).
69424 compared with similar codes
Compare codes
69424 vs 69436 vs 69433 vs 69421: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69436Tympanostomy
- 69424 removes an existing tube; 69436 describes placement of a new tube under general anesthesia.
- 69433Ear tube placement
- 69433 describes placement of a new tube using local or topical anesthesia, rather than removal of an existing tube under general anesthesia.
- 69421Myringotomy
- 69421 is an eardrum incision procedure under general anesthesia. It does not describe removing a ventilating tube.
69424 billing questions
When is 69424 appropriate instead of an insertion code?
Use 69424 for removing an existing ventilating tube when general anesthesia is required. Tube placement codes describe inserting a new tube, not removing one.
Does the code include same-day follow-up care?
Yes. The zero-day global period includes same-day preoperative and postoperative care.
How is bilateral removal reported?
For removal from both ears, report modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 69424. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 69424?
Document the ear treated, the tube removed, the reason for removal, and why general anesthesia was required.
What happens when other procedures are performed in the same session?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
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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