Billing code 69220: Mastoid cleaningMedicare rate & RVUs in Washington
Reports routine cleaning of a postmastoidectomy cavity, typically by an otolaryngologist removing debris during an office visit.
Medicare pays $80.40–$89.88 for 69220 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 69220 covers
An otolaryngologist typically uses direct visualization to remove debris, crusting, or accumulated material from a mastoid cavity created by prior surgery. This is the routine, simple cleaning service for a patient who returns for ongoing cavity care; it is not a procedure to remove impacted cerumen from the external ear canal. The service is commonly performed in an office, though it may also occur in a facility setting.
Document the mastoid cavity being treated, the material removed, and the work performed so the record supports simple rather than complicated cleaning. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed 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 service; 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 69220 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $80.40 | $44.53 |
| Seattle (King Cnty) | $89.88 | $48.08 |
How the 69220 rate is calculated
Each of 69220’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 · 69220
RVUs × geographic indexes × conversion factor
Work0.81
0.81 RVUs× 1.000 GPCI
Practice expense1.42
1.42 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
2.3500
Conversion factor
$33.4009
Medicare rate
$78.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69220
The CMS indicators that decide how 69220 is paid alongside other services.
CMS payment indicators · 69220
Mastoid cleaning
| 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) | 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69220 without 50 · national office
$78.49
Mastoid cleaning
69220-50 · Bilateral: 150%
$117.74
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).
69220 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69222Mastoid cleaning
- Both address mastoid cavity cleaning. Choose 69220 for routine, simple work and 69222 when the cleaning is complicated.
- 69210Impacted ear wax removal
- 69210 is for impacted cerumen removed from the external ear canal using instrumentation; 69220 is for a postmastoidectomy cavity.
- 69209Earwax removal
- 69209 addresses impacted external-canal cerumen removed by irrigation or lavage. It does not describe cleaning a mastoid cavity.
69220 billing questions
When should 69220 be selected instead of 69222?
Use 69220 for routine, simple cleaning of a mastoid cavity. Use 69222 when the documented cavity cleaning is complicated.
Is cleaning a mastoid cavity the same as removing earwax?
No. 69220 addresses debris or material in a postmastoidectomy cavity; 69209 and 69210 address impacted cerumen in the external ear canal.
How is bilateral cleaning reported?
The CMS payment rule specifies modifier 50 for bilateral treatment, paid at 150%. Document treatment of both mastoid cavities.
Is same-day evaluation or postoperative care separately included?
The 0-day global period includes same-day preoperative and postoperative care. The rule does not extend that inclusion to care on a later date.
Can an assistant or co-surgeon be paid for 69220?
Medicare does not pay an assistant at surgery for this service. 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
Fee sheets
Put 69220 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 →