Billing code 69000: Ear drainageMedicare rate & RVUs in Florida
Drainage of a simple abscess or hematoma of the external ear, such as the auricle, when the collection requires procedural evacuation.
Medicare pays $189.63–$209.01 for 69000 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 69000 covers
billing code 69000 covers straightforward drainage of an abscess or hematoma in the external ear, usually the auricle or pinna. The clinician opens the collection and evacuates its contents; this is distinct from treating an abscess within the external auditory canal. Otolaryngologists and other clinicians who manage acute ear lesions may perform the service in an office, clinic, or hospital outpatient setting. A traumatic auricular hematoma and an external-ear abscess are representative presentations.
Choose 69000 for simple drainage; use 69005 when drainage of the external-ear abscess or hematoma is complicated, and 69020 when the abscess is in the auditory canal. Document the site, diagnosis, collection, and work performed to support the selection. CMS assigns a 10-day global period, so related postoperative visits during that period are included. For same-session procedures, the highest-valued procedure is paid in full and other procedures are paid at 50%. When both ears are treated, 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 69000 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$189.63 to $209.01
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $199.69 | $124.57 |
| Miami | $209.01 | $131.82 |
| Rest Of Florida | $189.63 | $118.75 |
How the 69000 rate is calculated
Each of 69000’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 · 69000
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.46Practice expense 4.05Malpractice 0.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69000
69000 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69000
Ear drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69000
Ear drainage
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69000 without 50 · national office
$191.72
Ear drainage
69000-50 · Bilateral: 150%
$287.58
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).
69000 compared with similar codes
Compare codes
69000 vs 69005 vs 69020 vs 10060: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69005Ear drainage
- Both codes address an external-ear abscess or hematoma. Choose 69000 for simple drainage and 69005 when drainage is complicated.
- 69020Canal abscess drainage
- Use 69020 when the abscess is in the external auditory canal; 69000 is for the external ear, such as the auricle.
- 10060Abscess drainage
- 10060 describes simple or single abscess drainage at sites outside the external ear. For an external-ear collection, 69000 is the site-specific code.
69000 billing questions
When should 69000 be reported instead of 69005?
Report 69000 for simple drainage of an external-ear abscess or hematoma. Use 69005 when the drainage is complicated, with documentation supporting the complexity.
How does 69000 differ from 69020?
69000 is for a collection in the external ear, such as the auricle. 69020 is for an abscess in the external auditory canal.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in 69000.
How is 69000 reported when both ears are treated?
Report modifier 50 for bilateral treatment; CMS pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 69000. 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 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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