Billing code 69210: Impacted ear wax removalMedicare rate & RVUs in Washington
Report instrumental removal of impacted cerumen from an ear canal under direct visualization when the wax obstructs examination or requires clinical treatment.
Medicare pays $48.82–$54.16 for 69210 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 69210 covers
Code 69210 covers removal of impacted cerumen from the external auditory canal with an instrument under direct visualization. A physician or other qualified health care professional may use a curette, loop, forceps, or suction while viewing the canal with an otoscope, headlight, or microscope. The wax may obstruct assessment of the tympanic membrane or cause hearing loss, ear fullness, or discomfort. Primary care clinicians and otolaryngologists commonly perform this service in offices; it may also occur in facility settings.
Report 69210 for instrumental removal of an impaction; use 69209 when irrigation or lavage alone clears it. Document the impaction, ear or ears treated, instruments, and findings after removal. Medicare prices 69210 as bilateral, so report one unit when both ears are treated; modifier 50 does not increase payment. Routine same-day pre- and post-procedure care is included in its 0-day global period; a significant, separately identifiable E/M requires modifier 25 on the E/M code. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures subject to the standard multiple procedure reduction are paid at 50%. Assistant at surgery is not paid; co-surgeon and team-surgery billing 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 69210 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $48.82 | $27.02 |
| Seattle (King Cnty) | $54.16 | $28.75 |
How the 69210 rate is calculated
Each of 69210’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 · 69210
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.59Practice expense 0.77Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69210
The CMS indicators that decide how 69210 is paid alongside other services.
CMS payment indicators · 69210
Impacted ear wax removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
69210 without 51 · national office
$47.76
Impacted ear wax removal
69210-51 · Second procedure: 50%
$23.88
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
69210 compared with similar codes
Compare codes
69210 vs 69209 vs G0268 vs 69200 vs 69220: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69209Earwax removal
- 69209 is for removal by irrigation or lavage alone. 69210 requires instrumental removal, such as with a curette, forceps, or suction, under direct visualization.
- G0268Earwax removal
- G0268 describes a physician's removal of impacted cerumen on the same date as audiologic function testing. It is not an irrigation-only counterpart to 69210.
- 69200Ear canal removal
- 69200 is for extracting a foreign object, such as a bead or insect, from the external ear canal without general anesthesia. Use 69210 for instrumental removal of impacted cerumen.
- 69220Mastoid cleaning
- 69220 is for simple debridement of a surgically created mastoid cavity. 69210 removes impacted wax from the external auditory canal.
69210 billing questions
When is 69210 reported instead of 69209?
Use 69210 when impacted wax is removed with instruments such as a curette, forceps, or suction under direct visualization. Use 69209 when irrigation or lavage alone removes it.
Can 69210 be billed if the cerumen was not impacted?
No. Removing wax that is not impacted is part of the examination or other service and is not separately reported as 69210.
How are both ears handled for Medicare?
Report one unit when impacted cerumen is removed instrumentally from both ears. Medicare already prices 69210 as bilateral, so modifier 50 does not increase payment.
Is an office visit on the same day separately payable?
A significant, separately identifiable E/M may be reported with modifier 25 on the E/M code. Routine same-day pre- and post-procedure care is included in the 0-day global period.
What if the clinician irrigates first and then finishes with a curette?
When instrumentation is needed to complete removal of impacted cerumen in the same ear, report 69210 rather than reporting both 69209 and 69210 for that ear.
What documentation supports 69210?
Record the impaction, which ear was treated, the instruments used under direct visualization, and the findings after removal.
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
Fee sheets
Put 69210 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →