How Common Is Earwax Impaction? Prevalence & Cost
Earwax removal is a routine medical procedure, but what does it actually cost patients and the healthcare system?
It is actually quite a prevalent and costly medical concern. Approximately 8 million cerumen removal procedures are performed annually in the United States. Further, earwax is associated with roughly 12 million U.S. patient visits each year.[1]
But the actual cost itself of the procedure depends on a number of factors:
• Removal method: Irrigation and instrument-assisted procedures have different billing codes and payment rates
• Healthcare setting: Costs can differ between physician offices and hospital outpatient facilities
• Insurance coverage: Medicare, private insurance, and self-pay arrangements affect out-of-pocket costs
• Additional services: A medically necessary examination or other separately identifiable service may add to the total bill
Understanding these differences helps explain why a seemingly simple earwax problem can generate substantial healthcare spending.
How Common Is Earwax Impaction
Cerumen impaction affects up to 6% of the general population, 10% of children, and more than 30% of elderly and cognitively impaired patients.[1] These estimates show that earwax impaction affects people across age groups. The actual prevalence numbers ultimately, though, depend on how impaction is defined and measured.
For additional prevalence statistics, see our Earwax Buildup by the Numbers: 2026 Data Report.
What Does Earwax Removal Cost?
Professional removal of impacted cerumen (earwax) is generally reported using two Current Procedural Terminology (CPT) codes: 69209 for irrigation or lavage and 69210 for removal requiring instrumentation.[2]
The 2026 Medicare Physician Fee Schedule provides standardized reimbursement benchmarks, although actual payment varies by geographic location, provider, and setting.[2]
| Removal Method | CPT Code | 2026 National Medicare Payment |
|---|---|---|
| Ear Irrigation or lavage, physician office | CPT 69209 | $17.03 |
| Instrument-assisted removal, physician office | CPT 69210 | $47.76 |
| Instrument-assisted removal, non-physician office | CPT 69210 | $27.05 |
Instrument-assisted removal may involve specialized tools, including curettes, forceps, or microsuction, which uses gentle suction to extract accumulated earwax. Unlike irrigation, microsuction doesn’t require flushing the ear canal with water. When medically necessary and meeting the applicable coding requirements, microsuction may be billed under CPT code 69210.
These costs outlined in the chart above aren’t the only fees you might pay after a procedure. The specific procedure could be more expensive than just the amount that is being reimbursed through Medicare. For example, a separately billable evaluation or hospital facility charge can affect the final total when applicable.[3]
How Much Do Patients Actually Pay?
A provider's Medicare reimbursement is not necessarily the same as the patient's out-of-pocket cost. Below, we outline how the final patient cost may be figured out based on insurance type.
| Insurance situation | What determines patient cost |
|---|---|
| Original Medicare | Typically 20% of the Medicare-approved amount after the Part B deductible, when covered[3] |
| Medicare Advantage | Plan-specific copays, coinsurance, network rules, and medical necessity |
| Private insurance | Deductible, copay, coinsurance, coverage requirements, and provider network |
| Uninsured or self-pay | Provider's quoted cash price and any applicable visit or facility fees |
The Economic Burden of Earwax Impaction
The financial burden of earwax impaction on the healthcare system extends beyond just a singular doctor bill. With approximately 12 million patient visits and 8 million cerumen removal procedures annually in the United States, professional earwax removal has significant costs for the healthcare system.[1]
According to a May 2024 report from the American Medical Association (AMA), Medicare recorded 1,439,777 instrument-assisted cerumen (earwax) removal services in 2022.[4] A 2016 study published in JAMA Otolaryngology, Head & Neck Surgery also showed that in 2012 that $46.8 million was reimbursed from Medicare for earwax extraction in 2012.[5] These findings demonstrate that even relatively low-cost procedures can account for millions of dollars in healthcare spending when they have this high of a procedure volume.
The Earwax Removal Cost That Medical Bills Don’t Capture
Healthcare claims capture payments for covered services, but they don’t account for every cost associated with earwax impaction. Some hidden costs include:
• Time away from work because of time spent scheduling, traveling to, and attending appointments
• More than one visit when impaction persists or recurs
• Travel expenses for patients and/or caregivers to attend appointments
• Hearing aid maintenance, such as cleaning, filter replacement, troubleshooting and potential repairs
Repeat Visits and Follow-Up Care
Earwax impaction doesn’t always resolve after a single procedure.
The American Academy of Otolaryngology, Head and Neck Surgery Foundation's 2017 clinical practice guideline recommends reassessing patients after treatment and providing additional management if the impaction persists.[6]
For patients who need repeat appointments, the economic impact can include more medical costs, travel expenses, and time taken away from other duties.
Hearing Aid Users and Device Maintenance
Hearing aid users face an additional concern. These devices sit in the ear canal, which can get in the way of wax moving out of the ear naturally.
The 2017 clinical practice guideline says doctors should check hearing aid users for cerumen impaction during visits.[6] It also discusses how buildup can interfere with hearing aid performance and contribute to device maintenance issues.
If there are issues with the hearing aids, that could mean additional cleaning or troubleshooting is needed, which just adds to the total cost. However, the available evidence does not establish a reliable nationwide annual dollar cost that can be specifically attributed to hearing-related earwax problems.
What Do These Earwax Removal Costs Mean for At-Home Earwax Management?
Professional removal is a routine, established treatment for cerumen impaction. At-home management is another option for appropriate patients, with different methods and evidence supporting their use.
The 2017 clinical practice guideline identifies three management approaches:[6]
• Cerumenolytic agents (earwax-dissolving preparations): Products designed to help break down accumulated wax.
• Ear Irrigation: Flushing the ear canal with liquid.
• Manual removal: Clinician-performed extraction using specialized instruments, such as microsuction.
A 2018 Cochrane review evaluated 10 studies involving 623 participants and found that ear drops may be more effective than no treatment, although evidence was insufficient to establish that one preparation consistently outperformed another.[7]
Understanding Earwax Dissolving Drops
As mentioned above, earwax dissolving drops are one avenue for dealing with earwax at home. Different earwax dissolving drops use different formulations. Carbamide peroxide formulations and dual sodium bicarbonate or glycolic acid formulations are two potential approaches to manage excess earwax.
At eosera®, we have eosera® EAR WAX MD®, which is a patented dual-action formula of sodium bicarbonate and glycolic acid (U.S. Patent No. 10,596,106), clinically proven to dissolve earwax. It is labeled for ages 2 and up.
The formulation has been evaluated in laboratory and clinical research, including an in vitro study (a study performed outside a living body, not on patients) comparing earwax disintegration under controlled conditions.[8]
The appropriate approach depends on the patient's symptoms, medical history, and condition of the ear canal and eardrum. Ear drops and irrigation shouldn’t be used without medical guidance when a perforated eardrum, ear tubes, drainage, or other contraindications are suspected.
What the Cost Data Cannot Tell Us
Although Medicare claims and medical billing data help quantify spending, they don’t provide a complete picture of the economic burden of cerumen impaction.
Three important limitations include:
• Unrecorded episodes: Earwax buildup managed without a medical visit may never appear in insurance claims.
• Differences in billing: Claims depend on procedures performed, coding requirements, reimbursement policies, and insurance arrangements.
• Indirect expenses: Claims generally do not capture lost work time, travel expenses, or routine hearing aid maintenance.
These limitations also make it difficult to calculate a reliable nationwide annual cost of cerumen impaction across all patients, insurers, and healthcare settings.
Key Takeaways on Earwax Management
Earwax affects millions of Americans. It also accounts for a large financial burden on the healthcare system.
Even though the cost itself of the procedure may not be huge, the overall cost on the healthcare system is large because of the prevalence of these removal procedures.There are also a number of hidden costs, such as the potential need for multiple appointments and travel costs to attend visits.
Understanding these costs gives you a clearer picture of the significance involved in earwax management. With this in mind, you have more information as you navigate both clinical and at-home care.
FAQ
How much does professional earwax removal cost?
The cost depends on the removal method, healthcare setting, insurance coverage, and services provided. In the 2026 Medicare Physician Fee Schedule, national non-facility payment benchmarks are $17.03 for irrigation and $47.76 for instrument-assisted removal.[2] These amounts represent reimbursement benchmarks rather than the total price charged to patients. In the end, additional charges like office visits and facility fees might make the final charge higher.
Is earwax removal covered by insurance?
Earwax removal may be covered when it is medically necessary. Medicare coverage policies recognize certain circumstances involving symptomatic impacted wax or obstruction that interferes with necessary medical evaluation.[9] Private insurance coverage depends on plan requirements, medical necessity, provider networks, and cost-sharing rules. Patients should confirm coverage before scheduling a procedure.
How many people get earwax removed each year?
Approximately 8 million cerumen removal procedures are performed annually in the United States. Earwax is associated with roughly 12 million U.S. patient visits each year, illustrating just how routine professional management of cerumen buildup is.[1]
Is it cheaper to treat earwax at home?
At-home products cost less per use than a clinical visit, but the two are not interchangeable. Some impactions need a clinician. The decision should not be about cost. If you are a good candidate for managing earwax at home based on your scenario and are interested in learning more about eosera® EAR WAX MD®, visit here.
References
1. Sevy, J. O., Hohman, M. H., & Singh, A. (n.d.). Cerumen impaction removal. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/28846265/
2. American Speech-Language-Hearing Association. (2025). 2026 Medicare fee schedule for audiologists. https://www.asha.org/siteassets/reimbursement/2026-medicare-fee-schedule-for-audiologists.pdf
3. Medicare.gov. (n.d.). Doctor & other health care provider services. https://www.medicare.gov/coverage/doctor-other-health-care-provider-services
4. American Medical Association. (2024, May 13). May 2024 RUC recommendations (p. 454). https://www.ama-assn.org/system/files/may-2024-ruc-recommendations.pdf
5. Yang, E. L., Macy, T. M., Wang, K. H., & Durr, M. L. (2016). Economic and demographic characteristics of cerumen extraction claims to Medicare. JAMA Otolaryngology–Head & Neck Surgery, 142(2), 157–161. https://doi.org/10.1001/jamaoto.2015.3129
6. Schwartz, S. R., Magit, A. E., Rosenfeld, R. M., et al. (2017). Clinical practice guideline (update): Earwax (cerumen impaction). Otolaryngology–Head and Neck Surgery, 156(1_suppl), S1–S29. https://doi.org/10.1177/0194599816671491
7. Aaron, K., Cooper, T. E., Warner, L., & Burton, M. J. (2018). Ear drops for the removal of ear wax. Cochrane Database of Systematic Reviews, 2018(7), CD012171. https://doi.org/10.1002/14651858.CD012171.pub2
8. Knebl, J., Harty, B., Anderson, C. E., Dean, W. D., & Griffin, J. (2025). In vitro comparison of three earwax removal formulations for the disintegration of earwax. F1000Research, 5, 2784. https://doi.org/10.12688/f1000research.10279.2
9. Centers for Medicare & Medicaid Services. (2026). Cerumen (earwax) removal (Local Coverage Determination L33945). Medicare Coverage Database. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33945
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