CPT 69210
Global 000 ActiveRemove impacted ear wax uni
CPT 69210 Billing & Documentation Guide
CPT code 69210 (Remove impacted ear wax uni) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.59, a non-facility practice expense RVU of 0.77, and a malpractice RVU of 0.07, a total non-facility RVU of 1.43 and facility RVU of 0.81. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $48.95, though rates vary from $43 to $60.21 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 69210, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 69210 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 69210 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 69210
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.59 | 0.59 |
| Practice Expense RVU | 0.77 | 0.15 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 1.43 | 0.81 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 69210
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $52.11 | $27.61 | $49.48 - $60.21 | 29 |
| Florida | $50.06 | $29.29 | $47.81 - $52.39 | 3 |
| Georgia | $47.07 | $27.31 | $45.43 - $48.7 | 2 |
| Illinois | $49.1 | $29.09 | $46.84 - $51.06 | 4 |
| Michigan | $47.15 | $27.7 | $45.83 - $48.47 | 2 |
| North Carolina | $45.2 | $25.88 | $45.2 - $45.2 | 1 |
| New York | $52.51 | $29.41 | $45.78 - $55.89 | 5 |
| Ohio | $45.54 | $26.64 | $45.54 - $45.54 | 1 |
| Pennsylvania | $47.58 | $27.3 | $45.53 - $49.62 | 2 |
| Texas | $47.31 | $26.92 | $45.28 - $49.03 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 69210
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 69210 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0583T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 69210
What does CPT code 69210 mean? +
CPT code 69210 represents: Remove impacted ear wax uni. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 000.
What is the Medicare reimbursement for CPT 69210? +
The 2026 Medicare national average non-facility payment for CPT 69210 is $48.95. Rates range from $43 to $60.21 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 69210? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 69210? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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