Removal Of Impacted Ear Wax By Washing
What Medicare pays for 69209, what providers bill, and how the price varies across 53 states, drawn from CMS 2023 claims data.
69209 · the short answer
For removal of impacted ear wax by washing, Medicare pays about $10.94 while providers bill $57.90 on average, a 5.3× markup, a below-median markup. State-level Medicare rates range 60% from lowest to highest.
- Medicare pays
- $10.94
- Providers bill
- $57.90
- Markup
- 5.3×
- Markup percentile
- 47th
Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.
Price Range Across States
What You Might Pay
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
How we estimate these prices
These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Ear Surgery procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.
Where this markup sits nationally
Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate
5 more affordable than 47% of 8,901 procedures
Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Medicare Physician & Other Practitioners · 2023
Prices by State
| State | Medicare Payment | Billed Charge |
|---|---|---|
| District of Columbia | $13.40 | $57.64 |
| California | $13.29 | $59.69 |
| New Jersey | $13.16 | $63.25 |
| Guam | $12.71 | $30.66 |
| Hawaii | $12.44 | $56.29 |
| Connecticut | $11.96 | $87.47 |
| Massachusetts | $11.89 | $61.48 |
| Puerto Rico | $11.88 | $36.45 |
| Maryland | $11.84 | $49.68 |
| New York | $11.62 | $55.87 |
| Minnesota | $11.52 | $86.69 |
| Rhode Island | $11.41 | $46.89 |
| Alaska | $11.36 | $76.33 |
| Florida | $11.25 | $45.69 |
| Delaware | $11.22 | $46.29 |
| Virginia | $11.14 | $43.36 |
| Colorado | $11.11 | $48.71 |
| New Hampshire | $11.03 | $60.58 |
| Maine | $11.02 | $52.68 |
| North Dakota | $10.95 | $70.80 |
| Nevada | $10.94 | $67.10 |
| Washington | $10.88 | $53.24 |
| Illinois | $10.86 | $78.30 |
| Michigan | $10.72 | $46.22 |
| Texas | $10.70 | $50.76 |
| Arizona | $10.70 | $45.96 |
| Oregon | $10.69 | $54.09 |
| Pennsylvania | $10.56 | $51.78 |
| Georgia | $10.47 | $77.12 |
| South Dakota | $10.36 | $51.21 |
| Montana | $10.23 | $53.59 |
| Utah | $10.01 | $48.15 |
| North Carolina | $9.95 | $58.52 |
| Ohio | $9.92 | $47.32 |
| Wyoming | $9.92 | $63.09 |
| New Mexico | $9.91 | $45.76 |
| Indiana | $9.90 | $48.23 |
| West Virginia | $9.87 | $55.07 |
| Missouri | $9.83 | $41.75 |
| South Carolina | $9.81 | $44.67 |
| Nebraska | $9.81 | $57.85 |
| Louisiana | $9.80 | $78.70 |
| Wisconsin | $9.77 | $133.83 |
| Tennessee | $9.76 | $51.29 |
| Kansas | $9.71 | $52.47 |
| Alabama | $9.58 | $38.40 |
| Kentucky | $9.37 | $41.73 |
| Iowa | $9.36 | $51.12 |
| Oklahoma | $9.35 | $37.94 |
| Arkansas | $9.11 | $43.36 |
| Vermont | $9.05 | $48.59 |
| Mississippi | $8.93 | $53.80 |
| Idaho | $8.36 | $43.36 |
What the Data Says About Removal Of Impacted Ear Wax By Washing
Across 53 states with reporting providers, CPT code 69209 (Removal Of Impacted Ear Wax By Washing) shows a national average Medicare payment of $10.94 against an average billed charge of $57.90. That gap, a 5.3x markup, or 429% above the Medicare allowed amount, is narrower than most procedures in our dataset, suggesting providers price this code closer to what payers actually reimburse.
Ear Surgery procedures like this one saw 274.1K services billed to Medicare in 2023 by 72.1K distinct providers, serving 253.2K unique beneficiaries. State-level variation is significant: Idaho reports the lowest average payment at $8.36, while District of Columbia reports the highest at $13.40. A 60% spread this wide is typically a GPCI story: practice-expense and malpractice-premium components of the fee formula diverge sharply by locality even though the procedure code never changes.
Applying RAND 2024 commercial-to-Medicare ratios specific to the Ear Surgery category (2.24x), the estimated commercial insurance price lands near $36.92, with self-pay cash discounts commonly bringing the figure closer to $28.29. Within Ear Surgery, Removal Of Impacted Ear Wax By Washing ranks #83 of 83 tracked procedures by national average Medicare payment.
What to do with this
If you may have removal of impacted ear wax by washing done, these steps turn the numbers above into a real-world cost estimate.
- Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
- Compare removal of impacted ear wax by washing costs in your state, Medicare rates vary by locality. Browse states
- Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
- Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide
Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.
Frequently Asked Questions
How much does Removal Of Impacted Ear Wax By Washing cost?
Medicare's national average payment for Removal Of Impacted Ear Wax By Washing (CPT 69209) is $10.94, with providers billing $57.90 on average; state rates run from $8.36 to $13.40, a meaningful but not extreme spread.
Why do providers charge more than Medicare pays?
Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.
How much does Removal Of Impacted Ear Wax By Washing cost with insurance?
With commercial insurance, removal of impacted ear wax by washing costs an estimated $36.92 on average (range: $25.85-$51.69), a moderate premium over Medicare's $10.94. Without insurance, the estimated cash price is $28.29.
Which state has the lowest cost for Removal Of Impacted Ear Wax By Washing?
Idaho has the lowest average Medicare payment for Removal Of Impacted Ear Wax By Washing at $8.36, while District of Columbia has the highest at $13.40 - a meaningful $5.04 spread.
How many providers perform Removal Of Impacted Ear Wax By Washing?
Removal Of Impacted Ear Wax By Washing is a widely-performed procedure: 72.1K providers billed Medicare for it in 2023 across 53 states, together handling 274.1K services for 253.2K beneficiaries.
What is the billed-to-Medicare markup for Removal Of Impacted Ear Wax By Washing?
Providers bill 5.3x what Medicare pays for Removal Of Impacted Ear Wax By Washing - a below-median markup at 429% above the Medicare rate.
Related Guides
Tips to reduce out-of-pocket costs
Your right to upfront pricing
How Medicare payments work
Decode charges and codes
Why bills exceed actual costs
Geographic pricing factors
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology - how this data is sourced, computed, and verified.
Related
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.