$208.08
Choose 69433 when a ventilating tube is inserted under local or topical anesthesia. Code 69420 is for an eardrum incision without tube placement.
On this page
CMS RVU26D · Effective 2026-10-01
69433 Ear tube placement Medicare reimbursement rates in Hawaii
Report this service when a clinician creates an eardrum opening and places a ventilating tube using local or topical anesthesia. Compare 69433 office and facility rates across CMS payment localities in Hawaii.
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 69433 in Hawaii?
Hawaii 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
$219.22
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$125.04
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
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 Hawaii, from the same CMS release.
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.
No office rate
Use 69436 when the tube-placement procedure is performed under general anesthesia. Code 69433 is for local or topical anesthesia.
$142.63
Code 69424 describes removal of a ventilating tube, rather than creating an eardrum opening and inserting one.
Compare 69433 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
$219.22
Facility
$125.04
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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 69433 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
7,605
- Code
- 69433
- Physician work
- 1.53
- Practice expense
- 4.32
- Malpractice
- 0.21
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.53 | × 1.000 | 1.5300 |
| Practice expense | 4.32 | × 1.137 | 4.9118 |
| Malpractice | 0.21 | × 0.579 | 0.1216 |
| Total RVUs | 6.5634 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$219.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.53 | 1 |
| Practice expense | 4.32 | 1.137 |
| Malpractice | 0.21 | 0.579 |
(1.53 × 1 + 4.32 × 1.137 + 0.21 × 0.579) × $33.4009 = $219.22
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.53 | 1 |
| Practice expense | 1.84 | 1.137 |
| Malpractice | 0.21 | 0.579 |
(1.53 × 1 + 1.84 × 1.137 + 0.21 × 0.579) × $33.4009 = $125.04
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.
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.
7,60269420,,Incision of eardrum,A,,1.35,4.19,,1.76,,0.20,5.74,3.31,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60369421,,Incision of eardrum,A,,1.74,2.14,NA,2.14,,0.25,4.13,4.13,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60469424,,Remove ventilating tube,A,,0.83,2.98,,0.74,,0.09,3.90,1.66,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60569433,,Create eardrum opening,A,,1.53,4.32,,1.84,,0.21,6.06,3.58,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60669436,,Create eardrum opening,A,,1.96,2.09,NA,2.09,,0.28,4.33,4.33,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60769440,,Exploration of middle ear,A,,7.52,10.06,NA,10.06,,1.11,18.69,18.69,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60869450,,Eardrum revision,A,,5.55,8.52,NA,8.52,,0.81,14.88,14.88,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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