Parts of the Ear and the Billing Codes Tied to Each

The three areas of the ear, in the NIDCD's words

The National Institute on Deafness and Other Communication Disorders (NIDCD), part of the National Institutes of Health, explains the ear by following a sound wave from the air to the brain. It starts outside: "Sound waves enter the outer ear and travel through a narrow passageway called the ear canal, which leads to the eardrum." Then "the eardrum vibrates from the incoming sound waves and sends these vibrations to three tiny bones in the middle ear," and the institute names them: "These bones are called the malleus, incus, and stapes." The bones hand the vibrations on to the "cochlea, a snail-shaped structure filled with fluid, in the inner ear." Last, "the auditory nerve carries this electrical signal to the brain."

Read that way, the ear has three areas plus a link: the outer ear with its canal, the middle ear where the eardrum's vibrations reach three bones, the inner ear with the cochlea, and the auditory nerve running to the brain. MedlinePlus, the National Library of Medicine's health site, names the same route when it describes air conduction: sound reaches the inner ear "through the ear canal, eardrum, and bones of the middle ear."

These are definitions only. This page doesn't say what can go wrong in any part, how a part is examined, or what to do about it: those questions belong to an audiologist or a doctor. What it adds is the part the anatomy pages leave out, the billing code that goes with each part and what Medicare pays for it.

Which billing code goes with which part

A billing code's number doesn't say which part of the ear it concerns, so the figure takes that link from a named source each time. The amounts come from the CMS 2026 physician fee schedule, as a national amount before CMS adjusts it for the local area:

• Ear canal (outer ear). MedlinePlus writes that "the ear canal also has glands that produce a waxy oil called cerumen." Removal of impacted ear wax is billed under 69209 or 69210, at $17.03 and $47.76 in an office. CMS posts no facility amount for 69209 (NA) and $27.05 for 69210.
• Eardrum and middle ear. MedlinePlus calls tympanometry "a test used to detect problems in the ear drum and middle ear." Its code, 92567, comes to $16.03 in an office and $8.68 in a facility.
• Auditory nerve and brain stem. The NIDCD says the auditory brain stem response (ABR) "tests how the auditory nerve and brain stem (which carry sound from the ear to the brain) respond to sound." Codes 92651, 92652 and 92653 come to $80.16, $107.88 and $80.16 in an office, and CMS marks the facility amount NA for all three.

Each figure pays the clinician's part of the service; none is what a patient owes. We leave out the official wording of these codes, which the American Medical Association holds the copyright to, so ask the clinic which code it plans to bill. Our ear wax removal cost and ABR hearing test pages add hospital cash prices for these codes, and hearing test cost covers the other audiology codes.

The cochlea, and what implant surgery is billed at

The NIDCD adds one detail about how the cochlea works: "hair cells near the wide end of the snail-shaped cochlea detect higher-pitched sounds, such as an infant crying." Its page explains that bending of the hair cells creates the electrical signal the auditory nerve carries.

When a device takes over that work, the billing moves to another scale. Medicare's regulation lists cochlear implants and auditory brainstem implants among devices that work "by replacing the function of the middle ear, cochlea, or auditory nerve." The surgeon's part of cochlear implant surgery, code 69930, has a 2026 national facility amount of $1,059.81; CMS publishes no office amount for it (NA). The device and the hospital's share are paid on separate lines, which our cochlear implant cost page sets out with the hospital outpatient and surgery center rates.

Medicare's hearing aid rule, read part by part

Medicare's regulation on hearing aids, 42 CFR 411.15(d), is written in the language of ear anatomy. Its exclusion covers "air conduction hearing aids that provide acoustic energy to the cochlea via stimulation of the tympanic membrane with amplified sound" (the tympanic membrane is the eardrum), and bone conduction aids that work through the scalp or "by direct contact with the tympanic membrane or middle ear ossicles," the three middle ear bones.

The next paragraph sets apart devices that produce sound "by replacing the function of the middle ear, cochlea, or auditory nerve." It names two kinds: "osseointegrated implants in the skull bone that provide mechanical energy to the cochlea via a mechanical transducer," and cochlear implants and auditory brainstem implants. Those are not subject to the hearing aid exclusion.

So the dividing line in the rule runs through the ear itself: a device that stimulates the eardrum or the middle ear bones is a hearing aid in Medicare's terms, and a device that replaces what the middle ear, cochlea or auditory nerve does is not. The rule names device types; whether one person's claim is paid depends on the published coverage conditions and the plan. Our page on whether Medicare covers hearing aids sets out the exclusion and its exceptions.

Device amounts in Medicare's DMEPOS fee schedule

Medicare prices implanted hearing devices on its durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) fee schedule, with one amount per state. Across the non-rural state cells that carry an amount in the October 2026 file:

• L8614, a "cochlear device, includes all internal and external components": $22,998.52 in Idaho to $24,149.06 in Nevada.
• L8619, a replacement external speech processor and controller for a cochlear implant: $9,873.11 in Idaho to $10,367.03 in Nevada.
• L8690, an "auditory osseointegrated device, includes all internal and external components": $5,717.38 in Alaska to $6,289.09 in the U.S. Virgin Islands.

These descriptions are the public HCPCS wording CMS publishes. The amounts are fee schedule figures, not retail prices, and a cell left at zero or blank doesn't mean a device is free. Our pages on cochlear implant processor replacement and bone-anchored hearing aids cover each device in more depth.