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CMS RVU26D · Effective 2026-10-01

69420 in Redding

Office / nonfacility

$202.82

Base rate per service

Facility setting

$113.87

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 procedure

About 69420: Eardrum incision without tube placement

Report this service when a clinician makes an opening in the eardrum to drain middle-ear fluid or perform related myringotomy care without placing a tube.

An otolaryngologist typically makes a small incision in the tympanic membrane to access or drain middle-ear fluid. The service may include aspiration and/or eustachian tube inflation; no ventilating tube is placed. It is commonly performed in an office or outpatient setting for selected middle-ear conditions, such as fluid behind the eardrum. The incision may be performed on one or both ears.

Select this code for the incision service without tube insertion, rather than a code for tympanostomy with a tube. Document the clinical reason, the ear treated, the procedure performed, and whether fluid was aspirated. Medicare includes related postoperative visits during the 10-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with 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.

CMS billing rules for 69420

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 RVU1.35 · 24%
  • Practice expense (office) RVU4.19 · 73%
  • Malpractice RVU0.20 · 3%

13.4K

Medicare services in 2024 · #1317 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.

69420 compared with similar codes

Office rates for Redding, from the same CMS release.

69421

Myringotomy

General anesthesia, no tube

No office rate

Both involve an eardrum incision without tube placement; 69421 applies when general anesthesia is required.

69433

Ear tube placement

Local or topical anesthesia

$213.88

This code includes placement of a ventilating tube under local or topical anesthesia; 69420 describes incision without tube insertion.

69436

Tympanostomy

Tube insertion, general anesthesia

No office rate

This code includes ventilating tube placement when general anesthesia is required; 69420 is for incision without a tube.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 69420 is $203.40—$0.58 higher than the $202.82 rate in Redding. Both use the same code, release and participation basis.

69420 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $202.82

  2. Bakersfield

    $203.40

    $0.58 higher than Redding

  3. Chico

    $202.82

    The same base rate than Redding

  4. El Centro

    $202.86

    $0.04 higher than Redding

  5. Fresno

    $202.82

    The same base rate than Redding

  6. Hanford-Corcoran

    $202.82

    The same base rate than Redding

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

    $216.94

    $14.12 higher than Redding

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, 69420 ranges from $168.75 in Arkansas to $255.44 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 · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Merced

    California · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Modesto

    California · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Napa

    California · 69420

    Office

    $235.78

    Facility

    $128.80

    $32.96 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 69420

    Office

    $215.94

    Facility

    $120.00

    $13.12 higher than Redding for the office setting.

  • Rest Of California

    California · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 69420

    Office

    $204.99

    Facility

    $116.03

    $2.17 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 69420

    Office

    $213.06

    Facility

    $118.66

    $10.24 higher than Redding for the office setting.

  • Salinas

    California · 69420

    Office

    $212.27

    Facility

    $118.20

    $9.45 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 69420

    Office

    $217.44

    Facility

    $120.37

    $14.62 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 69420

    Office

    $249.77

    Facility

    $135.33

    $46.95 higher than Redding for the office setting.

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

    California · 69420

    Office

    $249.54

    Facility

    $135.10

    $46.72 higher than Redding for the office setting.

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

    California · 69420

    Office

    $255.44

    Facility

    $138.40

    $52.62 higher than Redding for the office setting.

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

    California · 69420

    Office

    $254.51

    Facility

    $137.47

    $51.69 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 69420

    Office

    $208.84

    Facility

    $116.40

    $6.02 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 69420

    Office

    $219.66

    Facility

    $121.04

    $16.84 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 69420

    Office

    $213.12

    Facility

    $118.48

    $10.30 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 69420

    Office

    $221.88

    Facility

    $122.21

    $19.06 higher than Redding for the office setting.

  • Stockton

    California · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 69420

    Office

    $235.45

    Facility

    $128.48

    $32.63 higher than Redding for the office setting.

  • Visalia

    California · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 69420

    Office

    $202.82

    Facility

    $113.87

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 69420

    Office

    $219.82

    Facility

    $124.21

    $17.00 higher than Redding for the office setting.

  • Miami

    Florida · 69420

    Office

    $207.67

    Facility

    $123.18

    $4.85 higher than Redding for the office setting.

  • Chicago

    Illinois · 69420

    Office

    $201.39

    Facility

    $119.82

    $1.43 lower than Redding for the office setting.

  • Manhattan

    New York · 69420

    Office

    $221.19

    Facility

    $126.88

    $18.37 higher than Redding for the office setting.

  • Alaska*

    Alaska · 69420

    Office

    $220.36

    Facility

    $133.92

    $17.54 higher than Redding for the office setting.

  • Alabama

    Alabama · 69420

    Office

    $171.33

    Facility

    $100.31

    $31.49 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 69420

    Office

    $168.75

    Facility

    $99.03

    $34.07 lower than Redding for the office setting.

  • Arizona

    Arizona · 69420

    Office

    $186.42

    Facility

    $107.77

    $16.40 lower than Redding for the office setting.

  • Colorado

    Colorado · 69420

    Office

    $199.76

    Facility

    $113.40

    $3.06 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 69420

    Office

    $204.80

    Facility

    $117.39

    $1.98 higher than Redding for the office setting.

  • Delaware

    Delaware · 69420

    Office

    $189.59

    Facility

    $109.40

    $13.23 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 69420

    Office

    $198.94

    Facility

    $116.72

    $3.88 lower than Redding for the office setting.

  • Rest Of Florida

    Florida · 69420

    Office

    $188.92

    Facility

    $111.33

    $13.90 lower than Redding for the office setting.

  • Atlanta

    Georgia · 69420

    Office

    $195.44

    Facility

    $112.98

    $7.38 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 69420

    Office

    $177.89

    Facility

    $105.49

    $24.93 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 69420

    Office

    $208.08

    Facility

    $115.80

    $5.26 higher than Redding for the office setting.

  • Iowa

    Iowa · 69420

    Office

    $175.80

    Facility

    $101.53

    $27.02 lower than Redding for the office setting.

  • Idaho

    Idaho · 69420

    Office

    $177.00

    Facility

    $102.33

    $25.82 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 69420

    Office

    $187.30

    Facility

    $112.63

    $15.52 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 69420

    Office

    $183.31

    Facility

    $109.20

    $19.51 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 69420

    Office

    $200.97

    Facility

    $117.62

    $1.85 lower than Redding for the office setting.

  • Indiana

    Indiana · 69420

    Office

    $178.07

    Facility

    $102.83

    $24.75 lower than Redding for the office setting.

  • Kansas

    Kansas · 69420

    Office

    $174.97

    Facility

    $101.60

    $27.85 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 69420

    Office

    $175.62

    Facility

    $103.46

    $27.20 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 69420

    Office

    $184.37

    Facility

    $108.00

    $18.45 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 69420

    Office

    $175.35

    Facility

    $103.52

    $27.47 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 69420

    Office

    $219.99

    Facility

    $123.08

    $17.17 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 69420

    Office

    $198.50

    Facility

    $113.04

    $4.32 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 69420

    Office

    $204.24

    Facility

    $117.15

    $1.42 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 69420

    Office

    $193.30

    Facility

    $111.17

    $9.52 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 69420

    Office

    $178.00

    Facility

    $103.33

    $24.82 lower than Redding for the office setting.

  • Southern Maine

    Maine · 69420

    Office

    $188.00

    Facility

    $107.56

    $14.82 lower than Redding for the office setting.

  • Detroit

    Michigan · 69420

    Office

    $191.41

    Facility

    $113.08

    $11.41 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 69420

    Office

    $180.41

    Facility

    $106.30

    $22.41 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 69420

    Office

    $191.08

    Facility

    $107.56

    $11.74 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 69420

    Office

    $183.03

    Facility

    $106.82

    $19.79 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 69420

    Office

    $185.02

    Facility

    $107.75

    $17.80 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 69420

    Office

    $172.23

    Facility

    $102.27

    $30.59 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 69420

    Office

    $170.52

    Facility

    $100.64

    $32.30 lower than Redding for the office setting.

  • Montana**

    Montana · 69420

    Office

    $191.71

    Facility

    $110.54

    $11.11 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 69420

    Office

    $179.93

    Facility

    $104.21

    $22.89 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 69420

    Office

    $187.75

    Facility

    $106.59

    $15.07 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 69420

    Office

    $176.79

    Facility

    $101.88

    $26.03 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 69420

    Office

    $196.62

    Facility

    $112.13

    $6.20 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 69420

    Office

    $217.41

    Facility

    $123.26

    $14.59 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 69420

    Office

    $207.05

    Facility

    $118.42

    $4.23 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 69420

    Office

    $181.45

    Facility

    $107.02

    $21.37 lower than Redding for the office setting.

  • Nevada**

    Nevada · 69420

    Office

    $190.75

    Facility

    $109.50

    $12.07 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 69420

    Office

    $226.78

    Facility

    $130.28

    $23.96 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 69420

    Office

    $208.45

    Facility

    $119.57

    $5.63 higher than Redding for the office setting.

  • Queens

    New York · 69420

    Office

    $223.03

    Facility

    $127.09

    $20.21 higher than Redding for the office setting.

  • Rest Of New York

    New York · 69420

    Office

    $182.74

    Facility

    $105.63

    $20.08 lower than Redding for the office setting.

  • Ohio

    Ohio · 69420

    Office

    $179.60

    Facility

    $105.50

    $23.22 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 69420

    Office

    $175.26

    Facility

    $102.78

    $27.56 lower than Redding for the office setting.

  • Portland

    Oregon · 69420

    Office

    $206.27

    Facility

    $116.09

    $3.45 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 69420

    Office

    $189.18

    Facility

    $108.34

    $13.64 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 69420

    Office

    $199.56

    Facility

    $115.07

    $3.26 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 69420

    Office

    $179.88

    Facility

    $105.37

    $22.94 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 69420

    Office

    $193.16

    Facility

    $111.10

    $9.66 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 69420

    Office

    $196.47

    Facility

    $112.63

    $6.35 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 69420

    Office

    $180.08

    Facility

    $105.09

    $22.74 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 69420

    Office

    $187.29

    Facility

    $106.12

    $15.53 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 69420

    Office

    $175.89

    Facility

    $102.11

    $26.93 lower than Redding for the office setting.

  • Austin

    Texas · 69420

    Office

    $199.17

    Facility

    $113.30

    $3.65 lower than Redding for the office setting.

  • Beaumont

    Texas · 69420

    Office

    $178.65

    Facility

    $104.79

    $24.17 lower than Redding for the office setting.

  • Brazoria

    Texas · 69420

    Office

    $189.35

    Facility

    $108.92

    $13.47 lower than Redding for the office setting.

  • Dallas

    Texas · 69420

    Office

    $190.62

    Facility

    $109.78

    $12.20 lower than Redding for the office setting.

  • Fort Worth

    Texas · 69420

    Office

    $189.31

    Facility

    $109.28

    $13.51 lower than Redding for the office setting.

  • Galveston

    Texas · 69420

    Office

    $189.95

    Facility

    $109.36

    $12.87 lower than Redding for the office setting.

  • Houston

    Texas · 69420

    Office

    $193.61

    Facility

    $113.02

    $9.21 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 69420

    Office

    $183.94

    Facility

    $106.91

    $18.88 lower than Redding for the office setting.

  • Utah

    Utah · 69420

    Office

    $182.64

    Facility

    $106.35

    $20.18 lower than Redding for the office setting.

  • Virginia

    Virginia · 69420

    Office

    $187.38

    Facility

    $107.59

    $15.44 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 69420

    Office

    $193.16

    Facility

    $111.10

    $9.66 lower than Redding for the office setting.

  • Vermont

    Vermont · 69420

    Office

    $187.02

    Facility

    $106.67

    $15.80 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 69420

    Office

    $198.13

    Facility

    $112.66

    $4.69 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 69420

    Office

    $224.52

    Facility

    $124.93

    $21.70 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 69420

    Office

    $181.22

    Facility

    $103.47

    $21.60 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 69420

    Office

    $176.27

    Facility

    $105.74

    $26.55 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 69420

    Office

    $189.98

    Facility

    $108.82

    $12.84 lower than Redding for the office setting.

See how rates vary across the country

69420 · 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.

$168.75

$229.13

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$220.361
AL$171.331
AR$168.751
AZ$186.421
CA$202.82–$255.4429
CO$199.761
CT$204.801
DC$219.821
DE$189.591
FL$188.92–$207.673
GA$177.89–$195.442
GU$208.081
HI$208.081
IA$175.801
ID$177.001
IL$183.31–$201.394
IN$178.071
KS$174.971
KY$175.621
LA$175.35–$184.372
MA$198.50–$219.992
MD$193.30–$219.823
ME$178.00–$188.002
MI$180.41–$191.412
MN$191.081
MO$172.23–$185.023
MS$170.521
MT$191.711
NC$179.931
ND$187.751
NE$176.791
NH$196.621
NJ$207.05–$217.412
NM$181.451
NV$190.751
NY$182.74–$226.785
OH$179.601
OK$175.261
OR$189.18–$206.272
PA$179.88–$199.562
PR$193.161
RI$196.471
SC$180.081
SD$187.291
TN$175.891
TX$178.65–$199.178
UT$182.641
VA$187.38–$219.822
VI$193.161
VT$187.021
WA$198.13–$224.522
WI$181.221
WV$176.271
WY$189.981

Explore 69420 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 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 69420 in Redding, the physician’s office rate is $202.82 and the facility-setting rate is $113.87: a difference of $88.95.

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 69420 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$223.10

$202.82 × 110% = $223.10

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.

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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 69420 in Redding.

PPRRVU2026_Oct_nonQPP.csv

7,602

Code
69420
Physician work
1.35
Practice expense
4.19
Malpractice
0.20

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 69420 in Redding
ComponentRVULocality factorAdjusted
Physician work1.35× 1.0171.3729
Practice expense4.19× 1.0964.5922
Malpractice0.20× 0.5360.1072
Total RVUs6.0724
Conversion factor× 33.4009

Office / nonfacility rate, Redding$202.82

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

Open 69420 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.351.017
Practice expense4.191.096
Malpractice0.20.536

(1.35 × 1.017 + 4.19 × 1.096 + 0.2 × 0.536) × $33.4009 = $202.82

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.351.017
Practice expense1.761.096
Malpractice0.20.536

(1.35 × 1.017 + 1.76 × 1.096 + 0.2 × 0.536) × $33.4009 = $113.87

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

69420 · Office / nonfacility

$202.82

Effective 2026-10-01

The base rate is $7.92 higher than on 2025-10-01, moving from $194.90 to $202.82 (4.1%).

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

    $194.90changed to$202.82

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.38 changed to 1.35
    • Practice expense RVU 4.13 changed to 4.19
    • 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: $194.90

    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$202.82$113.87RVU26D
2026-07-01$202.82$113.87RVU26C
2026-04-01$202.82$113.87RVU26B
2026-01-01$202.82$113.87RVU26A
2025-10-01$194.90$122.78RVU25D
2025-07-01$194.90$122.78RVU25C
2025-04-01$194.90$122.78RVU25B
2025-01-01$194.90$122.78RVU25A

69420 billing questions

How is 69420 different from 69421?

Both describe an eardrum incision without tube placement. Code 69421 is for the procedure requiring general anesthesia; 69420 is used when general anesthesia is not required.

Can aspiration be billed separately?

Aspiration associated with the myringotomy is included in 69420. The procedure may also include eustachian tube inflation.

When should a tube-placement code be used instead?

Use a tympanostomy code when a ventilating tube is inserted through the eardrum. Codes 69433 and 69436 distinguish tube placement by anesthesia circumstances.

How is the procedure reported when both ears are treated?

Report bilateral treatment with modifier 50. CMS pays the bilateral procedure at 150%.

What postoperative care is included?

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

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for 69420. 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 69420PPRRVU2026_Oct_nonQPP.csv, line 7,602 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet