How much does Medicare pay for CPT 69210?

Medicare allowed an average of $41.92 per service and paid $29.91 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $138.94, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 69210?

Removal of impacted ear wax. It was billed 1,300,408 times to 991,014 Medicare beneficiaries by 13,337 providers in 2024.

Does 69210 pay differently in an office than a hospital?

Yes. The allowed amount averaged $43.58 in an office setting and $23.19 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 69210 most?

Otolaryngology, with 834,588 services from 5,694 clinicians. Next are Physician Assistant, Nurse Practitioner, Internal Medicine.

CPT 69210

Removal of impacted ear wax

$41.92Medicare-allowed amount per service, averaged across 1,300,408 services

Providers submitted

$138.94

Asking price, not received

Medicare allowed

$41.92

The fee schedule figure

Medicare paid

$29.91

Balance is patient coinsurance

Providers submitted an average of $138.94 for this code and Medicare allowed $41.92 — 3.3× 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 $29.91 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $43.58
Hospital / facility: $23.19

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. 1,194,522 services were billed in an office setting and 105,886 in a facility.

Services: 1,300,408
Beneficiaries: 991,014
Providers billing it: 13,337
Total allowed: $54,513,103

What Medicare pays for CPT 69210

Across 1,300,408 services billed by 13,337 providers to 991,014 beneficiaries, Medicare allowed an average of $41.92 per service. That is 1.3 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 69210

Specialty	Services	Beneficiaries	Avg allowed	Providers
Otolaryngology	834,588	627,157	$43.47	5,694
Physician Assistant	194,541	146,265	$36.93	1,656
Nurse Practitioner	163,313	123,828	$37.08	2,013
Internal Medicine	46,043	40,162	$47.69	1,710
Family Practice	43,091	38,048	$45.86	1,891
General Practice	4,433	3,475	$38.93	68
Emergency Medicine	2,447	2,231	$48.64	94
Geriatric Medicine	2,212	1,836	$47.54	53
Plastic and Reconstructive Surgery	1,557	1,413	$36.55	11
General Surgery	1,057	838	$42.49	8
Certified Clinical Nurse Specialist	989	888	$38.24	6
Neurology	989	828	$49.66	5
Allergy/ Immunology	986	779	$46.98	23
Audiologist	815	573	$43.57	13
Maxillofacial Surgery	456	280	$50.77	2

69210 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	193,197	$39.52	$26.54	1,337
Florida	148,951	$42.71	$29.81	1,023
New York	111,659	$46.42	$29.31	815
New Jersey	64,670	$47.61	$31.20	487
Pennsylvania	64,264	$42.00	$29.57	659
Texas	63,810	$40.83	$29.52	793
Illinois	50,135	$42.86	$28.88	528
Massachusetts	42,551	$44.92	$29.32	424
Ohio	37,811	$38.67	$28.23	448
Maryland	37,683	$46.75	$31.17	341
Virginia	32,761	$43.17	$30.19	410
North Carolina	30,931	$40.83	$29.86	416
South Carolina	30,925	$40.77	$30.61	289
Michigan	26,779	$41.99	$29.83	329
Georgia	24,038	$41.80	$30.38	334
Arizona	23,199	$41.26	$30.02	331
Washington	21,583	$43.18	$28.99	227
Missouri	20,542	$38.73	$28.03	248
Indiana	19,172	$39.74	$29.96	282
Tennessee	18,428	$38.99	$29.80	282
Louisiana	18,159	$40.41	$30.60	214
Kentucky	16,321	$38.37	$29.19	199
Connecticut	15,846	$45.95	$30.66	146
Wisconsin	15,134	$36.48	$25.91	205
Iowa	14,412	$38.06	$28.54	192
Colorado	13,284	$42.78	$29.35	236
Alabama	11,719	$39.30	$30.46	161
Kansas	11,123	$38.53	$29.03	136
Minnesota	10,608	$38.70	$27.71	187
Oklahoma	10,455	$39.71	$29.72	166
Mississippi	9,327	$39.32	$30.68	110
Arkansas	8,366	$38.21	$29.54	142
Nebraska	8,147	$37.45	$28.42	129
Oregon	7,109	$42.14	$29.72	125
Delaware	6,552	$43.13	$30.90	60
Utah	6,526	$40.79	$29.12	125
New Hampshire	6,245	$37.61	$25.98	69
Nevada	5,394	$42.94	$31.26	81
West Virginia	4,753	$38.48	$27.47	54
Idaho	4,685	$36.77	$27.33	69
New Mexico	4,641	$39.35	$27.70	71
South Dakota	4,208	$36.87	$26.47	59
Montana	4,131	$38.64	$26.16	67
Maine	3,140	$35.85	$25.52	38
District of Columbia	2,979	$41.44	$26.84	35
Hawaii	2,207	$43.10	$29.07	36
North Dakota	2,202	$32.03	$23.05	55
Puerto Rico	2,024	$40.13	$28.29	41
Rhode Island	1,997	$45.68	$31.30	29
Wyoming	1,910	$42.66	$29.18	35
Vermont	1,724	$29.10	$20.21	26
Alaska	1,543	$52.26	$30.26	30
U.S. Virgin Islands	321	$41.75	$26.26	3
ZZ	71	$39.78	$29.70	2
AP	56	$41.71	$31.93	1

Related codes

69209Removal of impacted ear wax by washing$17.47
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.