Billing code 69433: Ear tube placementMedicare rate & RVUs

Medicare pays $202.41 for 69433 nationally in the office and $119.58 in a hospital or facility. Local office rates run $178.66–$268.55.

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

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.

Where 69433 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

69433 rates by state

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

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.

Payment rules and modifiers for 69433

69433 has a 10-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

69433 compared with similar codes

How to choose

69420Eardrum incision

Choose 69433 when a ventilating tube is inserted under local or topical anesthesia. Code 69420 is for an eardrum incision without tube placement.

69421Myringotomy

Both involve an eardrum incision without tube placement; 69421 is the general-anesthesia option, while 69433 includes tube insertion under local or topical anesthesia.

69436Tympanostomy

Use 69436 when the tube-placement procedure is performed under general anesthesia. Code 69433 is for local or topical anesthesia.

69424Tube removal

Code 69424 describes removal of a ventilating tube, rather than creating an eardrum opening and inserting one.

Codes related to 69433

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