How much does Medicare pay for CPT 69200?

Medicare allowed an average of $79.09 per service and paid $58.55 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $244.30, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 69200?

Removal of foreign body in ear canal. It was billed 9,961 times to 8,369 Medicare beneficiaries by 325 providers in 2024.

Does 69200 pay differently in an office than a hospital?

Yes. The allowed amount averaged $79.64 in an office setting and $43.36 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 69200 most?

Otolaryngology, with 8,699 services from 272 clinicians. Next are Family Practice, Physician Assistant, Nurse Practitioner.

CPT 69200

Removal of foreign body in ear canal

$79.09Medicare-allowed amount per service, averaged across 9,961 services

Providers submitted

$244.30

Asking price, not received

Medicare allowed

$79.09

The fee schedule figure

Medicare paid

$58.55

Balance is patient coinsurance

Providers submitted an average of $244.30 for this code and Medicare allowed $79.09 — 3.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $58.55 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $79.64
Hospital / facility: $43.36

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 9,811 services were billed in an office setting and 150 in a facility.

Services: 9,961
Beneficiaries: 8,369
Providers billing it: 325
Total allowed: $787,815

What Medicare pays for CPT 69200

Across 9,961 services billed by 325 providers to 8,369 beneficiaries, Medicare allowed an average of $79.09 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 69200

Specialty	Services	Beneficiaries	Avg allowed	Providers
Otolaryngology	8,699	7,338	$79.41	272
Family Practice	424	275	$85.28	5
Physician Assistant	414	370	$68.44	21
Nurse Practitioner	243	216	$66.10	16
Internal Medicine	134	123	$92.09	7
Cardiology	22	22	$94.14	2
General Surgery	13	13	$83.08	1
Emergency Medicine	12	12	$78.07	1

69200 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	3,616	$74.81	$51.12	64
Florida	1,575	$84.05	$62.74	42
New York	1,290	$88.45	$55.87	57
New Jersey	375	$88.37	$59.35	25
Colorado	267	$76.88	$54.86	5
District of Columbia	239	$83.88	$59.78	1
Pennsylvania	237	$75.78	$53.88	15
Texas	213	$78.55	$58.88	7
Maryland	187	$84.24	$57.02	11
Arizona	159	$76.01	$58.98	7
South Carolina	159	$72.99	$58.52	4
Virginia	146	$74.31	$55.34	8
Massachusetts	141	$83.69	$54.77	7
Michigan	141	$69.61	$49.16	5
Rhode Island	121	$81.40	$56.95	4
Connecticut	92	$82.05	$53.80	5
North Carolina	91	$67.96	$52.50	6
Ohio	89	$78.23	$50.84	6
Iowa	88	$84.92	$61.28	3
Louisiana	69	$76.73	$60.96	3
Illinois	68	$72.57	$54.52	5
Georgia	66	$67.76	$53.73	4
Arkansas	66	$71.06	$58.33	4
Tennessee	65	$71.38	$61.19	4
Alabama	43	$64.09	$56.20	2
Nevada	41	$82.23	$66.87	1
Missouri	37	$56.95	$50.82	2
Washington	36	$76.90	$54.61	3
Indiana	32	$85.59	$73.80	2
Delaware	31	$75.06	$55.63	2
Mississippi	30	$63.22	$58.04	2
Kansas	26	$62.98	$47.43	2
Wisconsin	24	$90.53	$68.89	1
Kentucky	21	$70.38	$65.99	1
Oregon	19	$71.00	$53.59	1
Oklahoma	19	$63.62	$51.71	1
Montana	15	$43.23	$27.07	1
Nebraska	14	$77.78	$57.19	1
New Hampshire	13	$70.94	$53.61	1

Related codes

69210Removal of impacted ear wax$41.92
69209Removal of impacted ear wax by washing$17.47
69220Simple removal of skin debris and drainage of mastoid cavity$77.51
69222Complex removal of skin debris and drainage of mastoid cavity$224.70

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.