$44.82–$46.67
Both codes address impacted cerumen, but 69209 is for irrigation or lavage and 69210 is for removal requiring instrumentation.
On this page
CMS RVU26D · Effective 2026-10-01
69209 Earwax removal Medicare reimbursement rates in Maine
Report this code for irrigation or lavage to remove impacted cerumen from one ear canal, rather than instrumentation or routine ear cleaning. Compare 69209 office and facility rates across CMS payment localities in Maine.
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 69209 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$15.57–$16.76
2 of 2 localities have a supported rate.
Facility setting
No supported rate
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.
Ear procedure
About 69209: Impacted cerumen removal by irrigation
Report this code for irrigation or lavage to remove impacted cerumen from one ear canal, rather than instrumentation or routine ear cleaning.
This service uses irrigation or lavage to dislodge and remove impacted cerumen from one external ear canal. It is commonly performed in an office or clinic when wax obstructs the canal; clinical staff may perform the irrigation under physician supervision. It describes wax removal, not routine ear cleaning or extraction of a foreign body. The instrumentation method for impacted cerumen is reported with a different code.
Report one unit for one ear; report bilateral treatment with modifier 50. CMS applies a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. As an incident-to service, this code is billed only when performed under physician supervision. Assistant-at-surgery services are not paid, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 69209
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Professional and technical components
- Incident-to service: billed only when performed under physician supervision.
- 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 RVU0.00 · 0%
- Practice expense (office) RVU0.50 · 98%
- Malpractice RVU0.01 · 2%
276.8K
Medicare services in 2024 · #328 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.
69209 compared with similar codes
Office rates for Maine, from the same CMS release.
$76.19–$80.00
Use 69200 for a foreign body in the external ear canal removed without general anesthesia; 69209 is for impacted cerumen removed by irrigation or lavage.
No office rate
Use 69205 for external ear canal foreign-body removal with general anesthesia. It is not the irrigation method for impacted cerumen described by 69209.
Compare 69209 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$15.57
Facility
Unavailable
Southern Maine →
Office / nonfacility
$16.76
Facility
Unavailable
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69209 billing questions
How is this different from 69210?
Use 69209 when impacted cerumen is removed by irrigation or lavage. Use 69210 when removal requires instrumentation.
Can the code be reported for both ears?
Yes. The code is unilateral; report bilateral treatment with modifier 50. CMS pays a bilateral procedure reported with modifier 50 at 150%.
Can clinical staff perform the irrigation?
The service may be performed as an incident-to service, but it may be billed only when performed under physician supervision.
Is this the right code for a foreign object in the ear canal?
No. This code is for impacted cerumen removed by irrigation or lavage. Foreign-body removal is reported with 69200 or 69205, depending on the circumstances.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and the other procedure at 50% under the standard multiple procedure reduction.
Is same-day follow-up care included?
Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
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.
7,59169155,,Extensive ear/neck surgery,A,,22.77,16.76,NA,16.76,,3.32,42.85,42.85,0,090,0.07,0.79,0.14,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,59269200,,Clear outer ear canal,A,,0.75,1.59,,0.39,,0.11,2.45,1.25,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,59369205,,Clear outer ear canal,A,,1.18,1.27,NA,1.27,,0.17,2.62,2.62,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,59469209,,Remove impacted ear wax uni,A,,0.00,0.50,,0.50,NA,0.01,0.51,0.51,5,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,59569210,,Remove impacted ear wax uni,A,,0.59,0.77,,0.15,,0.07,1.43,0.81,0,000,0.00,0.00,0.00,2,2,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,59669220,,Clean out mastoid cavity,A,,0.81,1.42,,0.40,,0.12,2.35,1.33,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,59769222,,Clean out mastoid cavity,A,,1.41,4.87,,2.15,,0.21,6.49,3.77,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00