How much does Medicare pay for CPT 69209?

Medicare allowed an average of $17.47 per service and paid $11.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $59.40, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 69209?

Removal of impacted ear wax by washing. It was billed 76,716 times to 71,494 Medicare beneficiaries by 4,166 providers in 2024.

Does 69209 pay differently in an office than a hospital?

Yes. The allowed amount averaged $17.47 in an office setting and $15.91 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 69209 most?

Family Practice, with 25,067 services from 1,362 clinicians. Next are Internal Medicine, Nurse Practitioner, Physician Assistant.

CPT 69209

Removal of impacted ear wax by washing

$17.47Medicare-allowed amount per service, averaged across 76,716 services

Providers submitted

$59.40

Asking price, not received

Medicare allowed

$17.47

The fee schedule figure

Medicare paid

$11.70

Balance is patient coinsurance

Providers submitted an average of $59.40 for this code and Medicare allowed $17.47 — 3.4× 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 $11.70 (67%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $17.47
Hospital / facility: $15.91

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. 76,660 services were billed in an office setting and 56 in a facility.

Services: 76,716
Beneficiaries: 71,494
Providers billing it: 4,166
Total allowed: $1,340,229

What Medicare pays for CPT 69209

Across 76,716 services billed by 4,166 providers to 71,494 beneficiaries, Medicare allowed an average of $17.47 per service. 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 69209

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	25,067	23,225	$18.07	1,362
Internal Medicine	18,541	17,009	$18.85	929
Nurse Practitioner	17,596	16,655	$15.70	1,037
Physician Assistant	10,424	9,924	$16.21	625
Otolaryngology	1,659	1,468	$16.52	38
Emergency Medicine	1,612	1,563	$19.10	85
General Practice	577	541	$19.31	26
Geriatric Medicine	315	286	$20.31	15
Hospitalist	174	159	$19.62	10
Pediatric Medicine	123	119	$18.12	8
General Surgery	105	94	$16.67	5
Nephrology	91	82	$23.49	3
Cardiology	82	70	$17.08	4
Pulmonary Disease	64	59	$16.90	4
Allergy/ Immunology	47	43	$18.13	3

69209 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	13,728	$20.08	$11.84	677
Florida	5,867	$16.60	$11.60	308
Massachusetts	3,458	$17.63	$10.81	195
Arizona	3,454	$17.08	$11.67	186
Virginia	3,383	$17.47	$11.67	192
Illinois	3,205	$17.23	$11.92	165
Pennsylvania	2,826	$17.22	$11.99	160
Texas	2,492	$16.92	$11.90	136
Indiana	2,232	$16.73	$12.13	132
Maryland	2,203	$17.05	$11.08	118
Minnesota	2,160	$18.99	$11.75	130
New York	2,129	$18.03	$12.11	101
Ohio	2,086	$16.16	$11.74	120
Washington	2,036	$17.02	$10.25	122
Tennessee	1,899	$15.88	$12.59	114
Wisconsin	1,792	$16.85	$11.08	110
North Carolina	1,429	$15.48	$11.41	89
South Carolina	1,280	$15.81	$11.97	76
Iowa	1,279	$15.88	$11.75	72
Nebraska	1,267	$16.64	$11.99	57
Kansas	1,165	$15.79	$11.07	50
Michigan	1,028	$17.65	$12.69	56
Colorado	1,003	$18.75	$12.01	59
Georgia	948	$16.78	$12.83	57
Montana	908	$16.31	$10.57	48
Connecticut	863	$17.26	$10.70	35
New Jersey	859	$19.14	$12.05	51
Arkansas	845	$15.41	$12.45	48
Delaware	819	$16.85	$11.74	40
Mississippi	787	$14.05	$11.56	32
Missouri	671	$16.33	$11.68	39
Wyoming	649	$16.92	$10.63	39
Nevada	623	$16.35	$10.77	38
North Dakota	600	$17.69	$11.68	33
Kentucky	588	$16.02	$12.41	37
Oregon	527	$16.86	$11.17	33
Oklahoma	492	$14.74	$11.26	30
Alabama	401	$15.19	$12.27	21
Idaho	384	$14.53	$10.23	25
Louisiana	367	$16.24	$12.66	15
South Dakota	292	$17.06	$12.33	16
New Mexico	284	$16.44	$11.37	17
New Hampshire	269	$18.26	$11.24	15
Alaska	232	$17.87	$10.44	13
Rhode Island	231	$18.22	$11.92	12
West Virginia	225	$15.56	$11.60	14
Utah	163	$17.09	$11.77	12
Hawaii	107	$18.36	$10.96	8
Vermont	98	$15.96	$12.08	6
Maine	61	$18.72	$12.15	5
District of Columbia	22	$19.47	$10.88	2

Related codes

69210Removal of impacted ear wax$41.92
69220Simple removal of skin debris and drainage of mastoid cavity$77.51
69200Removal of foreign body in ear canal$79.09
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.