69210

Removal of impacted ear wax

Medicare pricing data for 84,739 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 1.5 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Removal of impacted ear wax (HCPCS code 69210) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $42.86, but hospitals typically charge $133.43 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$8.57

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $42.86, your out-of-pocket cost would be approximately $8.57. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$42.86
Average Hospital Charge
$133.43
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$133.43
Medicare Allowed$42.86
Medicare Payment$30.39

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $30.39 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$53$2182662,252+23.9%
New Jersey$48$1642,70968,906+12.5%
Maryland$48$1251,66541,371+11.3%
New York$47$2174,760123,733+10.4%
Connecticut$47$1611,20518,741+9.3%
Rhode Island$46$1162393,027+8.1%
Massachusetts$45$1652,68850,256+5.6%
Nevada$45$1205376,673+4.6%
Virginia$44$1192,22436,412+2.7%
Washington$44$1291,78926,973+2.4%
Colorado$44$1191,65016,423+2.3%
Illinois$44$1423,55358,695+1.8%
Delaware$44$1073617,299+1.6%
Wyoming$43$1402042,291+1.0%
District of Columbia$43$1181402,750+0.8%
Florida$43$1075,148157,701+0.7%
Pennsylvania$43$1124,63275,727+0.1%
Hawaii$43$1002582,543-0.2%
Texas$43$1225,28869,600-0.4%
Michigan$42$1022,90532,377-1.3%
Oregon$42$1378198,945-1.6%
Georgia$42$1372,11729,109-2.1%
Arizona$42$1011,83427,362-2.2%
California$42$1236,863198,796-2.6%
South Carolina$42$1151,57632,700-3.0%
North Carolina$41$1253,10739,202-3.6%
Utah$41$1117037,468-4.5%
Louisiana$41$1301,11819,916-4.9%
Oklahoma$41$1081,21913,186-5.4%
Indiana$40$1132,20424,169-5.7%
Puerto Rico$40$62772,240-5.8%
Alabama$40$811,12914,334-5.8%
Missouri$40$1141,67025,028-6.3%
New Mexico$40$1005165,625-7.3%
New Hampshire$40$1765947,458-7.3%
Minnesota$40$1621,50412,833-7.8%
Ohio$39$1263,44245,671-8.0%
Montana$39$1093874,489-8.0%
Tennessee$39$1332,16823,276-8.1%
Mississippi$39$14386911,108-8.2%
Arkansas$39$11486010,717-8.6%
Kentucky$39$921,29718,079-8.8%
Kansas$39$11284011,201-8.9%
West Virginia$39$1244085,452-9.4%
Iowa$39$1311,08917,394-9.4%
South Dakota$38$1082534,972-10.2%
Nebraska$38$1157719,304-10.3%
Wisconsin$38$2331,59518,728-12.5%
Idaho$37$1225416,069-14.3%
Maine$36$1184364,428-15.3%
North Dakota$34$972472,345-20.2%
Vermont$32$1022112,201-26.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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