$176.05
Use 69000 for simple drainage of an abscess or hematoma on the external ear. Use 69020 when the abscess is within the external auditory canal.
On this page
CMS RVU26D · Effective 2026-10-01
69020 Canal abscess drainage Medicare reimbursement rates in Kentucky
Drainage of a localized external auditory canal abscess, reported when a clinician incises and evacuates an abscess within the ear canal. Compare 69020 office and facility rates across CMS payment localities in Kentucky.
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 69020 in Kentucky?
Kentucky 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
$212.67
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$123.89
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 procedure
About 69020: External auditory canal abscess drainage
Drainage of a localized external auditory canal abscess, reported when a clinician incises and evacuates an abscess within the ear canal.
This service treats a localized collection of infection within the external auditory canal, such as a painful, fluctuant canal abscess. An otolaryngologist commonly performs the procedure, although other qualified clinicians may drain it in an office, emergency department, or other appropriate setting. The work centers on the canal; drainage of an abscess or hematoma on the outer ear is a different service.
Documentation should identify the affected canal, describe the abscess findings, and support that drainage was performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When performed with other procedures in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 69020
- 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 RVU1.49 · 21%
- Practice expense (office) RVU5.27 · 76%
- Malpractice RVU0.21 · 3%
531
Medicare services in 2024 · #3503 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.
69020 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$205.87
69005 covers complicated drainage of an external-ear abscess or hematoma. The location for 69020 is the external auditory canal.
$44.71
69210 is for removal of impacted cerumen requiring instrumentation, not incision and drainage of a canal abscess.
Compare 69020 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
Kentucky →
Office / nonfacility
$212.67
Facility
$123.89
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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 69020 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,582
- Code
- 69020
- Physician work
- 1.49
- Practice expense
- 5.27
- Malpractice
- 0.21
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.49 | × 1.000 | 1.4900 |
| Practice expense | 5.27 | × 0.889 | 4.6850 |
| Malpractice | 0.21 | × 0.915 | 0.1921 |
| Total RVUs | 6.3672 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$212.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.49 | 1 |
| Practice expense | 5.27 | 0.889 |
| Malpractice | 0.21 | 0.915 |
(1.49 × 1 + 5.27 × 0.889 + 0.21 × 0.915) × $33.4009 = $212.67
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.49 | 1 |
| Practice expense | 2.28 | 0.889 |
| Malpractice | 0.21 | 0.915 |
(1.49 × 1 + 2.28 × 0.889 + 0.21 × 0.915) × $33.4009 = $123.89
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.
69020 billing questions
How is canal abscess drainage different from 69000 or 69005?
69020 is for an abscess within the external auditory canal. Codes 69000 and 69005 address drainage of an abscess or hematoma on the external ear, with the choice between them based on the service's complexity.
Are related postoperative visits separately reported?
Related postoperative visits during the 10-day global period are included in 69020.
How should bilateral canal drainage be reported?
Use modifier 50 for bilateral treatment; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports 69020?
Document that the abscess is in the external auditory canal, the clinical findings supporting an abscess, and that drainage was performed. Distinguish the canal site from an external-ear lesion.
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.
7,57968899,,Unlisted px lacrimal system,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,58069000,,Drg xtrnl ear absc/hem smpl,A,,1.46,4.05,,1.83,,0.23,5.74,3.52,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,58169005,,Drg xtrnl ear absc/hem comp,A,,2.11,4.22,,1.94,,0.33,6.66,4.38,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,58269020,,Drg xtrnl aud canal abscess,A,,1.49,5.27,,2.28,,0.21,6.97,3.98,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,58369090,,Ear piercing,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
7,58469100,,Biopsy of external ear,A,,0.79,1.91,,0.26,,0.07,2.77,1.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,58569105,,Biopsy of external ear canal,A,,0.83,3.37,,0.78,,0.11,4.31,1.72,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631