$157.83
69105 describes biopsy of an external auditory canal lesion. Choose 69540 when the documented procedure is excision of an aural polyp, not diagnostic sampling.
On this page
CMS RVU26D · Effective 2026-10-01
69540 Aural polyp Medicare reimbursement rates in Guam
Reports surgical removal of an aural polyp, commonly encountered with chronic ear disease, rather than diagnostic sampling or treatment of another ear lesion. Compare 69540 office and facility rates across CMS payment localities in Guam.
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.
What does Medicare pay for 69540 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$229.94
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$127.78
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otolaryngology surgery
About 69540: Excision of an aural polyp
Reports surgical removal of an aural polyp, commonly encountered with chronic ear disease, rather than diagnostic sampling or treatment of another ear lesion.
CPT 69540 represents surgical removal of an aural polyp, often tissue protruding into the ear canal in the setting of chronic middle-ear inflammation or infection. An otolaryngologist, frequently an otologist, removes the polyp under direct visualization in an office or facility setting. The code describes excision of the polyp, not simply examination or diagnostic sampling of an ear lesion.
Document the affected ear, the polyp and its site, the removal performed, and relevant underlying ear disease; distinguish excision from biopsy. Medicare assigns a 10-day global period, including related postoperative visits during that period. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery services are not paid under the statutory restriction; co-surgeons and team surgery are not permitted.
CMS billing rules for 69540
- 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 RVU1.22 · 19%
- Practice expense (office) RVU4.89 · 78%
- Malpractice RVU0.18 · 3%
379
Medicare services in 2024 · #3782 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.
69540 compared with similar codes
Office rates for Guam, from the same CMS release.
$440.98
69145 applies to excision of a soft-tissue lesion in the external auditory canal when it is not documented as an aural polyp.
$508.51
69110 concerns a lesion of the external ear. 69540 is for an aural polyp, not a lesion on the outer ear.
Compare 69540 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$229.94
Facility
$127.78
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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 69540 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,615
- Code
- 69540
- Physician work
- 1.22
- Practice expense
- 4.89
- Malpractice
- 0.18
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.22 | × 1.000 | 1.2200 |
| Practice expense | 4.89 | × 1.137 | 5.5599 |
| Malpractice | 0.18 | × 0.579 | 0.1042 |
| Total RVUs | 6.8841 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$229.94
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.22 | 1 |
| Practice expense | 4.89 | 1.137 |
| Malpractice | 0.18 | 0.579 |
(1.22 × 1 + 4.89 × 1.137 + 0.18 × 0.579) × $33.4009 = $229.94
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.22 | 1 |
| Practice expense | 2.2 | 1.137 |
| Malpractice | 0.18 | 0.579 |
(1.22 × 1 + 2.2 × 1.137 + 0.18 × 0.579) × $33.4009 = $127.78
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.
69540 billing questions
How is 69540 distinguished from a biopsy of an ear-canal lesion?
Use 69540 when the documented service is excision of an aural polyp. When tissue is sampled for diagnosis rather than excised as a polyp, consider 69105.
Is an aural polyp the same as any external auditory canal soft-tissue lesion?
No. 69540 identifies an aural polyp; 69145 is for excision of a documented external auditory canal soft-tissue lesion that is not characterized as an aural polyp.
How should bilateral excision be reported?
For excision performed on both sides, report modifier 50. CMS pays bilateral procedures at 150%.
What postoperative care is included?
Related postoperative visits during the 10-day global period are included in the procedure.
How does the multiple-procedure rule affect 69540?
When it is the highest-valued procedure in the same session, it is paid in full; other procedures are paid at 50%. If another procedure is highest-valued, 69540 is among the other procedures.
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.
7,61269511,,Extensive mastoid surgery,A,,13.36,19.20,NA,19.20,,1.95,34.51,34.51,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61369530,,Extensive mastoid surgery,A,,19.87,22.67,NA,22.67,,3.04,45.58,45.58,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61469535,,Remove part of temporal bone,A,,36.48,28.98,NA,28.98,,5.31,70.77,70.77,0,090,0.07,0.79,0.14,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61569540,,Excision aural polyp,A,,1.22,4.89,,2.20,,0.18,6.29,3.60,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61669550,,Exc aurl glomus tum trnscanl,A,,10.87,16.86,NA,16.86,,1.58,29.31,29.31,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61769552,,Exc aurl glomus tum trnsmstd,A,,19.31,20.65,NA,20.65,,2.82,42.78,42.78,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61869554,,Exc aurl glomus tum extended,A,,35.07,26.74,NA,26.74,,5.11,66.92,66.92,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014