Cerumen (Earwax) Removal

Medicare covers physician-performed removal of impacted cerumen (CPT 69210, HCPCS G0268) when removal by a non-physician would pose an unacceptable risk of complications or when cerumen is symptomatic, obstructs clinical evaluation (e.g., tympanic membrane exam), or impedes medically necessary audiometry. Routine removal of asymptomatic, non-impacted cerumen is not covered; documentation must support medical necessity and, when applicable, that the E/M service is a significant, separately identifiable service. HCPCS G0268 is payable to a physician only when the physician's skill is required and an employed audiologist performs same-day audiologic testing; audiologists may not bill CPT 69210 or G0268.

"Medically necessary removal of impacted cerumen requiring a physician's skill is covered when removal by a non-physician poses an unacceptable risk of complications such as tympanic membrane perfor..."