Billing code 69145: Ear canal excisionMedicare rate & RVUs in Illinois
Reports operative excision of a lesion in the external auditory canal, including cases where the tympanic membrane is involved or removed.
Medicare pays $385.71–$423.82 for 69145 in the office in Illinois, from Rest Of Illinois to Chicago. 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 69145 covers
This service removes a lesion from the external auditory canal rather than sampling it solely for diagnosis. An otolaryngologist typically performs the excision in an operating room or, when clinically appropriate, another procedural setting. The operative record should identify the lesion’s canal location and describe its extent, the tissues removed, and any tympanic membrane involvement. A lesion such as a canal mass may require excision when removal, rather than biopsy alone, is the planned treatment.
Select this code for the documented canal lesion excision; use a simple-excision or extensive-excision sibling when the operative service matches that distinct level. The record should support the scope of surgery and whether the tympanic membrane was involved. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 69145 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$385.71 to $423.82
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $423.82 | $255.31 |
| East St. Louis | $393.71 | $239.45 |
| Rest Of Illinois | $385.71 | $232.62 |
| Suburban Chicago | $423.70 | $251.50 |
How the 69145 rate is calculated
Each of 69145’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 · 69145
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.63Practice expense 9.10Malpractice 0.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69145
69145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69145
Ear canal excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.07/0.79/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69145
Ear canal excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69145 without 50 · national office
$404.82
Ear canal excision
69145-50 · Bilateral: 150%
$607.23
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).
69145 compared with similar codes
Compare codes
69145 vs 69140 vs 69150 vs 69105: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69140Ear canal excision
- 69140 is the simple-excision option. This code represents a different canal lesion excision level; the operative note should support the service performed and any tympanic membrane involvement.
- 69150Ear canal surgery
- 69150 is the extensive-excision sibling. Select between the codes according to the documented scope of canal surgery.
- 69105Ear canal biopsy
- 69105 is for a diagnostic biopsy of the external auditory canal. Report 69145 when the service is excision of the lesion rather than tissue sampling alone.
69145 billing questions
How is this different from 69140?
69140 is for a simple external auditory canal lesion excision. Use 69145 when the documented service fits the canal excision level represented by this code, including its tympanic membrane qualifier.
When should 69105 be reported instead?
69105 describes biopsy of an external auditory canal lesion. Choose 69145 when the operative service is excision of the lesion, not merely obtaining tissue for diagnosis.
What documentation supports this code?
Document the lesion’s external auditory canal location, the extent of the excision, tissues removed, and whether the tympanic membrane was involved.
Can modifier 50 be used when both ears are treated?
Yes. CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%.
Does the code include postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS restricts assistant-at-surgery payment for this code. 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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