$191.08
Choose 69421 for a myringotomy performed under general anesthesia. 69420 is the related code when the procedure is performed without that anesthesia distinction.
On this page
CMS RVU26D · Effective 2026-10-01
69421 Myringotomy Medicare reimbursement rates in Minnesota
Reports an eardrum incision to access or drain the middle ear when the myringotomy is performed under general anesthesia, without tube placement. Compare 69421 office and facility rates across CMS payment localities in Minnesota.
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 69421 in Minnesota?
Minnesota 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
No supported rate
Facility setting
$134.14
1 of 1 localities have a supported rate.
Payment area: Minnesota
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 69421: Myringotomy under general anesthesia
Reports an eardrum incision to access or drain the middle ear when the myringotomy is performed under general anesthesia, without tube placement.
An otolaryngologist makes an opening in the tympanic membrane to access or drain the middle ear, often for middle-ear fluid or pressure problems. The service may include aspiration of middle-ear contents. This code is for a myringotomy performed under general anesthesia and does not represent placement of a ventilating tube. It is commonly performed in an operating room or ambulatory surgery setting, including for patients who cannot tolerate the procedure awake.
Report the service when the operative documentation supports the eardrum incision and general anesthesia; distinguish it from a myringotomy performed without general anesthesia and from procedures that also place a tube. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, 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 69421
- 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 RVU1.74 · 42%
- Practice expense (office) RVU2.14 · 52%
- Malpractice RVU0.25 · 6%
365
Medicare services in 2024 · #3812 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.
69421 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$201.66
69433 includes insertion of a ventilating tube and is performed under local or topical anesthesia. 69421 covers the incision without tube placement under general anesthesia.
No office rate
69436 includes ventilating-tube insertion under general anesthesia. Use 69421 when no tube is placed.
Compare 69421 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
Minnesota →
Office / nonfacility
Unavailable
Facility
$134.14
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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 69421 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
7,603
- Code
- 69421
- Physician work
- 1.74
- Practice expense
- 2.14
- Malpractice
- 0.25
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.74 | × 1.000 | 1.7400 |
| Practice expense | 2.14 | × 1.029 | 2.2021 |
| Malpractice | 0.25 | × 0.296 | 0.0740 |
| Total RVUs | 4.0161 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$134.14
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.74 | 1 |
| Practice expense | 2.14 | 1.029 |
| Malpractice | 0.25 | 0.296 |
(1.74 × 1 + 2.14 × 1.029 + 0.25 × 0.296) × $33.4009 = $134.14
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.
69421 billing questions
How does 69421 differ from 69420?
Both describe a myringotomy without tube placement. Use 69421 when the procedure requires general anesthesia; 69420 is the corresponding service without that anesthesia distinction.
Should 69421 be reported when a ventilating tube is inserted?
Use the applicable tube-placement code when a ventilating tube is inserted. 69421 describes the incision and middle-ear access without tube placement.
Can the service be reported for both ears?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Are postoperative visits separately payable during the global period?
Related postoperative visits for 10 days are included in the 10-day global period.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 69421. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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.
7,60069320,,Rebuild outer ear canal,A,,16.75,23.52,NA,23.52,,2.44,42.71,42.71,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60169399,,Unlisted px external ear,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
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
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002