FeeBase
Log inGet started
Menu

CPT code 69604: Mastoid revision, resulting in tympanoplasty2026 Medicare rate & RVUs

Revision mastoid surgery that includes tympanoplasty is reported when an otologic surgeon revises a previously operated mastoid and repairs the eardrum.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $986.33 for 69604 nationally in a facility.

Medicare rate · 69604

Mastoid revision, resulting in tympanoplasty

Office or facility?

Work RVUs
13.85
Total RVUs
29.53
Global days
090

National rate · 2026

$986.33

Facility setting, before claim adjustments.

See every locality for 69604 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 69604 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 69604 covers

An otolaryngologist, often an otologist, uses this code for revision surgery on a previously operated mastoid that includes tympanoplasty. The operation addresses the mastoid and reconstructs the tympanic membrane; it is performed in an operating room, commonly for persistent or recurrent disease in an ear with prior mastoid surgery. The operative report should make clear that this is revision work and describe both the mastoid portion and the eardrum repair.

Report the code when the revision results in tympanoplasty, rather than selecting a sibling code based on a different resulting mastoid procedure. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 69604 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

69604 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$900.01
AlaskaUnavailable$1,216.99
ArizonaUnavailable$962.47
ArkansasUnavailable$889.27
Atlanta, GAUnavailable$1,008.58
Austin, TXUnavailable$1,006.03
Bakersfield, CAUnavailable$1,012.54
Baltimore area, MDUnavailable$1,043.03
Beaumont, TXUnavailable$940.48
Brazoria, TXUnavailable$971.08

69604 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
69604 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 69604 rate is calculated

Each of 69604’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 69604

RVUs × geographic indexes × conversion factor

Office or facility?

Work13.85

13.85 RVUs× 1.000 GPCI

Practice expense13.66

13.66 RVUs× 1.000 GPCI

Malpractice2.02

2.02 RVUs× 1.000 GPCI

Adjusted RVUs

29.5300

Conversion factor

$33.4009

Medicare rate

$986.33

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 69604

69604 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69604

Mastoid revision, resulting in tympanoplasty

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.07/0.79/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 69604

Mastoid revision, resulting in tympanoplasty

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

69604 without 50 · national facility

$986.33

Mastoid revision, resulting in tympanoplasty

69604-50 · Bilateral: 150%

$1,479.50

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

69604 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 69604

    Mastoid revision, resulting in tympanoplasty13.85 wRVU

    Not priced

  • 69601

    Mastoid revision, complete mastoidectomy result13.11 wRVU

    Not priced

  • 69603

    Mastoid revision, resulting in radical mastoidectomy13.85 wRVU

    Not priced

  • 69641

    Tympanoplasty, mastoidectomy, no ossicular reconstruction12.57 wRVU

    Not priced

  • 69631

    Tympanoplasty, no mastoidectomy or chain reconstruction9.8 wRVU

    Not priced

How to choose

69601Mastoid revisionComplete mastoidectomy result
Both describe revision mastoid surgery, but 69601 represents a different resulting mastoid procedure. Choose the code that matches the operative result; 69604 is the tympanoplasty-resulting service.
69603Mastoid revisionResulting in radical mastoidectomy
This is a sibling revision mastoidectomy code for a different resulting procedure. Use 69604 when the revision includes tympanoplasty as its result.
69641TympanoplastyMastoidectomy, no ossicular reconstruction
69641 describes tympanoplasty performed with mastoidectomy; 69604 is for revision of a previously operated mastoid resulting in tympanoplasty.
69631TympanoplastyNo mastoidectomy or chain reconstruction
69631 is tympanoplasty without mastoidectomy. Choose 69604 when the operation includes revision mastoid work as well as tympanoplasty.

Codes related to 69604

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 69604
CodeHow it relatesNational office range
Same family
69601Mastoid revision, complete mastoidectomy resultRevision mastoidectomy sibling with a different resulting mastoid procedure.No office rate
69602Mastoid revision, modified radical outcomeRevision mastoidectomy sibling with a different resulting mastoid procedure.No office rate
69603Mastoid revision, resulting in radical mastoidectomyRevision mastoidectomy sibling with a different resulting mastoid procedure.No office rate
Used instead
69641Tympanoplasty, mastoidectomy, no ossicular reconstructionTympanoplasty with mastoidectomy when the service is not coded as this revision procedure.No office rate
69631Tympanoplasty, no mastoidectomy or chain reconstructionTympanoplasty without mastoidectomy, for a different operative scope.No office rate

69604 billing questions

How does this differ from codes 69601 through 69603?

Those sibling codes represent revision mastoid procedures resulting in other specified mastoidectomy types. Use 69604 when the revision results in tympanoplasty.

Can tympanoplasty be reported separately from the mastoid revision?

The tympanoplasty is part of the service represented by 69604. Do not separately report the same eardrum repair work.

What documentation supports reporting 69604?

The operative report should describe the prior mastoid surgery, the revision performed, and the tympanoplasty completed as part of the operation.

How is bilateral surgery reported?

Use modifier 50 for bilateral reporting; CMS pays the bilateral procedure at 150%.

Is an assistant surgeon payable for this procedure?

CMS applies a statutory restriction, so an assistant at surgery is not paid for 69604. Co-surgeons and team surgery are also not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 69604PPRRVU2026_Oct_nonQPP.csv, line 7,622 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 69604 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 69604 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet