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CMS RVU26D · Effective 2026-10-01

69433 in Merced

Office / nonfacility

$213.88

Base rate per service

Facility setting

$123.09

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Otolaryngology

About 69433: Tympanostomy with tube, local anesthesia

Report this service when a clinician creates an eardrum opening and places a ventilating tube using local or topical anesthesia.

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.

CMS billing rules for 69433

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.53 · 25%
  • Practice expense (office) RVU4.32 · 71%
  • Malpractice RVU0.21 · 3%

36.2K

Medicare services in 2024 · #911 by national volume

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.

69433 compared with similar codes

Office rates for Merced, from the same CMS release.

69420

Eardrum incision

No ventilating tube

$202.82

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

69421

Myringotomy

General anesthesia, no tube

No office rate

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

69436

Tympanostomy

Tube insertion, general anesthesia

No office rate

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

69424

Tube removal

Requires general anesthesia

$138.90

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

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 69433 is $214.49—$0.61 higher than the $213.88 rate in Merced. Both use the same code, release and participation basis.

69433 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $213.88

  2. Bakersfield

    $214.49

    $0.61 higher than Merced

  3. Chico

    $213.88

    The same base rate than Merced

  4. El Centro

    $213.91

    $0.03 higher than Merced

  5. Fresno

    $213.88

    The same base rate than Merced

  6. Hanford-Corcoran

    $213.88

    The same base rate than Merced

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $228.55

    $14.67 higher than Merced

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 69433 ranges from $178.66 in Arkansas to $268.55 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Modesto

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Napa

    California · 69433

    Office

    $248.06

    Facility

    $138.89

    $34.18 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 69433

    Office

    $227.46

    Facility

    $129.55

    $13.58 higher than Merced for the office setting.

  • Redding

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 69433

    Office

    $216.15

    Facility

    $125.36

    $2.27 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 69433

    Office

    $224.51

    Facility

    $128.18

    $10.63 higher than Merced for the office setting.

  • Salinas

    California · 69433

    Office

    $223.68

    Facility

    $127.68

    $9.80 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 69433

    Office

    $229.01

    Facility

    $129.94

    $15.13 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 69433

    Office

    $262.63

    Facility

    $145.83

    $48.75 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 69433

    Office

    $262.39

    Facility

    $145.59

    $48.51 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 69433

    Office

    $268.55

    Facility

    $149.11

    $54.67 higher than Merced for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 69433

    Office

    $267.58

    Facility

    $148.13

    $53.70 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 69433

    Office

    $220.08

    Facility

    $125.73

    $6.20 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 69433

    Office

    $231.25

    Facility

    $130.61

    $17.37 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 69433

    Office

    $224.54

    Facility

    $127.95

    $10.66 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 69433

    Office

    $233.59

    Facility

    $131.87

    $19.71 higher than Merced for the office setting.

  • Stockton

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 69433

    Office

    $247.72

    Facility

    $138.54

    $33.84 higher than Merced for the office setting.

  • Visalia

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 69433

    Office

    $213.88

    Facility

    $123.09

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 69433

    Office

    $231.65

    Facility

    $134.07

    $17.77 higher than Merced for the office setting.

  • Miami

    Florida · 69433

    Office

    $219.05

    Facility

    $132.82

    $5.17 higher than Merced for the office setting.

  • Chicago

    Illinois · 69433

    Office

    $212.57

    Facility

    $129.32

    $1.31 lower than Merced for the office setting.

  • Manhattan

    New York · 69433

    Office

    $233.17

    Facility

    $136.91

    $19.29 higher than Merced for the office setting.

  • Alaska*

    Alaska · 69433

    Office

    $234.19

    Facility

    $145.97

    $20.31 higher than Merced for the office setting.

  • Alabama

    Alabama · 69433

    Office

    $181.33

    Facility

    $108.85

    $32.55 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 69433

    Office

    $178.66

    Facility

    $107.51

    $35.22 lower than Merced for the office setting.

  • Arizona

    Arizona · 69433

    Office

    $196.93

    Facility

    $116.66

    $16.95 lower than Merced for the office setting.

  • Colorado

    Colorado · 69433

    Office

    $210.72

    Facility

    $122.59

    $3.16 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 69433

    Office

    $216.01

    Facility

    $126.80

    $2.13 higher than Merced for the office setting.

  • Delaware

    Delaware · 69433

    Office

    $200.23

    Facility

    $118.38

    $13.65 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 69433

    Office

    $209.95

    Facility

    $126.04

    $3.93 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 69433

    Office

    $199.59

    Facility

    $120.40

    $14.29 lower than Merced for the office setting.

  • Atlanta

    Georgia · 69433

    Office

    $206.28

    Facility

    $122.12

    $7.60 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 69433

    Office

    $188.17

    Facility

    $114.28

    $25.71 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 69433

    Office

    $219.22

    Facility

    $125.04

    $5.34 higher than Merced for the office setting.

  • Iowa

    Iowa · 69433

    Office

    $185.92

    Facility

    $110.12

    $27.96 lower than Merced for the office setting.

  • Idaho

    Idaho · 69433

    Office

    $187.17

    Facility

    $110.96

    $26.71 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 69433

    Office

    $197.98

    Facility

    $121.77

    $15.90 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 69433

    Office

    $193.81

    Facility

    $118.18

    $20.07 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 69433

    Office

    $212.08

    Facility

    $127.01

    $1.80 lower than Merced for the office setting.

  • Indiana

    Indiana · 69433

    Office

    $188.27

    Facility

    $111.48

    $25.61 lower than Merced for the office setting.

  • Kansas

    Kansas · 69433

    Office

    $185.08

    Facility

    $110.20

    $28.80 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 69433

    Office

    $185.80

    Facility

    $112.16

    $28.08 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 69433

    Office

    $194.85

    Facility

    $116.90

    $19.03 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 69433

    Office

    $185.52

    Facility

    $112.21

    $28.36 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 69433

    Office

    $231.73

    Facility

    $132.82

    $17.85 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 69433

    Office

    $209.45

    Facility

    $122.23

    $4.43 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 69433

    Office

    $215.42

    Facility

    $126.54

    $1.54 higher than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 69433

    Office

    $204.08

    Facility

    $120.25

    $9.80 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 69433

    Office

    $188.21

    Facility

    $112.01

    $25.67 lower than Merced for the office setting.

  • Southern Maine

    Maine · 69433

    Office

    $198.52

    Facility

    $116.43

    $15.36 lower than Merced for the office setting.

  • Detroit

    Michigan · 69433

    Office

    $202.17

    Facility

    $122.24

    $11.71 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 69433

    Office

    $190.76

    Facility

    $115.13

    $23.12 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 69433

    Office

    $201.66

    Facility

    $116.42

    $12.22 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 69433

    Office

    $193.45

    Facility

    $115.66

    $20.43 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 69433

    Office

    $195.50

    Facility

    $116.64

    $18.38 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 69433

    Office

    $182.31

    Facility

    $110.91

    $31.57 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 69433

    Office

    $180.52

    Facility

    $109.20

    $33.36 lower than Merced for the office setting.

  • Montana**

    Montana · 69433

    Office

    $202.40

    Facility

    $119.56

    $11.48 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 69433

    Office

    $190.21

    Facility

    $112.93

    $23.67 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 69433

    Office

    $198.24

    Facility

    $115.41

    $15.64 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 69433

    Office

    $186.94

    Facility

    $110.48

    $26.94 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 69433

    Office

    $207.45

    Facility

    $121.22

    $6.43 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 69433

    Office

    $229.19

    Facility

    $133.10

    $15.31 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 69433

    Office

    $218.41

    Facility

    $127.95

    $4.53 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 69433

    Office

    $191.84

    Facility

    $115.88

    $22.04 lower than Merced for the office setting.

  • Nevada**

    Nevada · 69433

    Office

    $201.38

    Facility

    $118.47

    $12.50 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 69433

    Office

    $238.96

    Facility

    $140.47

    $25.08 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 69433

    Office

    $219.89

    Facility

    $129.19

    $6.01 higher than Merced for the office setting.

  • Queens

    New York · 69433

    Office

    $235.04

    Facility

    $137.13

    $21.16 higher than Merced for the office setting.

  • Rest Of New York

    New York · 69433

    Office

    $193.11

    Facility

    $114.42

    $20.77 lower than Merced for the office setting.

  • Ohio

    Ohio · 69433

    Office

    $189.91

    Facility

    $114.28

    $23.97 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 69433

    Office

    $185.41

    Facility

    $111.44

    $28.47 lower than Merced for the office setting.

  • Portland

    Oregon · 69433

    Office

    $217.45

    Facility

    $125.42

    $3.57 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 69433

    Office

    $199.75

    Facility

    $117.25

    $14.13 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 69433

    Office

    $210.60

    Facility

    $124.37

    $3.28 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 69433

    Office

    $190.19

    Facility

    $114.15

    $23.69 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 69433

    Office

    $203.89

    Facility

    $120.15

    $9.99 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 69433

    Office

    $207.38

    Facility

    $121.82

    $6.50 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 69433

    Office

    $190.39

    Facility

    $113.85

    $23.49 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 69433

    Office

    $197.75

    Facility

    $114.92

    $16.13 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 69433

    Office

    $186.03

    Facility

    $110.74

    $27.85 lower than Merced for the office setting.

  • Austin

    Texas · 69433

    Office

    $210.08

    Facility

    $122.44

    $3.80 lower than Merced for the office setting.

  • Beaumont

    Texas · 69433

    Office

    $188.93

    Facility

    $113.55

    $24.95 lower than Merced for the office setting.

  • Brazoria

    Texas · 69433

    Office

    $199.98

    Facility

    $117.89

    $13.90 lower than Merced for the office setting.

  • Dallas

    Texas · 69433

    Office

    $201.30

    Facility

    $118.79

    $12.58 lower than Merced for the office setting.

  • Fort Worth

    Texas · 69433

    Office

    $199.94

    Facility

    $118.27

    $13.94 lower than Merced for the office setting.

  • Galveston

    Texas · 69433

    Office

    $200.60

    Facility

    $118.35

    $13.28 lower than Merced for the office setting.

  • Houston

    Texas · 69433

    Office

    $204.45

    Facility

    $122.19

    $9.43 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 69433

    Office

    $194.37

    Facility

    $115.76

    $19.51 lower than Merced for the office setting.

  • Utah

    Utah · 69433

    Office

    $193.04

    Facility

    $115.17

    $20.84 lower than Merced for the office setting.

  • Virginia

    Virginia · 69433

    Office

    $197.89

    Facility

    $116.47

    $15.99 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 69433

    Office

    $203.89

    Facility

    $120.15

    $9.99 lower than Merced for the office setting.

  • Vermont

    Vermont · 69433

    Office

    $197.50

    Facility

    $115.50

    $16.38 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 69433

    Office

    $209.04

    Facility

    $121.82

    $4.84 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 69433

    Office

    $236.44

    Facility

    $134.80

    $22.56 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 69433

    Office

    $191.50

    Facility

    $112.14

    $22.38 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 69433

    Office

    $186.53

    Facility

    $114.55

    $27.35 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 69433

    Office

    $200.59

    Facility

    $117.75

    $13.29 lower than Merced for the office setting.

See how rates vary across the country

69433 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$178.66

$241.22

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$234.191
AL$181.331
AR$178.661
AZ$196.931
CA$213.88–$268.5529
CO$210.721
CT$216.011
DC$231.651
DE$200.231
FL$199.59–$219.053
GA$188.17–$206.282
GU$219.221
HI$219.221
IA$185.921
ID$187.171
IL$193.81–$212.574
IN$188.271
KS$185.081
KY$185.801
LA$185.52–$194.852
MA$209.45–$231.732
MD$204.08–$231.653
ME$188.21–$198.522
MI$190.76–$202.172
MN$201.661
MO$182.31–$195.503
MS$180.521
MT$202.401
NC$190.211
ND$198.241
NE$186.941
NH$207.451
NJ$218.41–$229.192
NM$191.841
NV$201.381
NY$193.11–$238.965
OH$189.911
OK$185.411
OR$199.75–$217.452
PA$190.19–$210.602
PR$203.891
RI$207.381
SC$190.391
SD$197.751
TN$186.031
TX$188.93–$210.088
UT$193.041
VA$197.89–$231.652
VI$203.891
VT$197.501
WA$209.04–$236.442
WI$191.501
WV$186.531
WY$200.591

Explore 69433 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 69433 in Merced, the physician’s office rate is $213.88 and the facility-setting rate is $123.09: a difference of $90.79.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 69433 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$235.27

$213.88 × 110% = $235.27

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 69433 in Merced.

PPRRVU2026_Oct_nonQPP.csv

7,605

Code
69433
Physician work
1.53
Practice expense
4.32
Malpractice
0.21

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 69433 in Merced
ComponentRVULocality factorAdjusted
Physician work1.53× 1.0171.5560
Practice expense4.32× 1.0964.7347
Malpractice0.21× 0.5360.1126
Total RVUs6.4033
Conversion factor× 33.4009

Office / nonfacility rate, Merced$213.88

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

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Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.531.017
Practice expense4.321.096
Malpractice0.210.536

(1.53 × 1.017 + 4.32 × 1.096 + 0.21 × 0.536) × $33.4009 = $213.88

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.531.017
Practice expense1.841.096
Malpractice0.210.536

(1.53 × 1.017 + 1.84 × 1.096 + 0.21 × 0.536) × $33.4009 = $123.09

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

69433 · Office / nonfacility

$213.88

Effective 2026-10-01

The base rate is $8.14 higher than on 2025-10-01, moving from $205.74 to $213.88 (4.0%).

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

    $205.74changed to$213.88

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.57 changed to 1.53
    • Practice expense RVU 4.25 changed to 4.32
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $205.74

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$213.88$123.09RVU26D
2026-07-01$213.88$123.09RVU26C
2026-04-01$213.88$123.09RVU26B
2026-01-01$213.88$123.09RVU26A
2025-10-01$205.74$134.67RVU25D
2025-07-01$205.74$134.67RVU25C
2025-04-01$205.74$134.67RVU25B
2025-01-01$205.74$134.67RVU25A

69433 billing questions

When should 69433 be chosen instead of 69420?

Use 69433 when a ventilating tube is placed through the eardrum opening under local or topical anesthesia. Code 69420 describes an incision without tube placement.

How does 69433 differ from 69436?

Both involve eardrum opening and tube placement. The distinction is the anesthetic approach: 69433 is for local or topical anesthesia, while 69436 is for general anesthesia.

Can both ears be reported?

Yes. For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.

Are related postoperative visits separately reported?

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

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for 69433. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 69433PPRRVU2026_Oct_nonQPP.csv, line 7,605 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet