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CPT code 69610: Eardrum repair, patch or perforation preparation2026 Medicare rate & RVUs in Puerto Rico

Reports a limited repair of a tympanic membrane perforation, such as edge preparation and patch placement, without more extensive middle-ear reconstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality2.7K Medicare services in 2024

In Puerto Rico, Medicare pays $384.17 for 69610 in the office and $250.11 when it’s performed in a hospital or facility.

$384.17Office (non-facility)
$250.11Hospital or facility
+0.5%vs the national office rate ($382.11)

Check a contract rate as a % of Medicare · 69610 nationwide

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

We’ll open 69610 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 69610 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 69610 covers

An otolaryngologist uses this service for a limited repair of a tympanic membrane perforation, often by preparing the perforation margin and applying a patch. It is commonly performed in an office or outpatient setting for a persistent eardrum opening when a patch-based repair is appropriate. The service may include preparation of the perforation site; a patch may or may not be used.

Choose this code when the documented work is limited to the eardrum repair, rather than a more extensive tympanoplasty involving middle-ear reconstruction. The operative note should identify the perforation, the repair technique, and whether site preparation or a patch was used. Related postoperative visits during the 10-day global period are included. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. For bilateral repair, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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.

How Puerto Rico compares for 69610

Across 109 of 109 payment localities, the office rate for 69610 runs from $341.64 in Arkansas to $483.89 in San Benito County, CA. Puerto Rico pays $384.17. The RVUs are the same everywhere; the geographic indexes change the dollars.

69610 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$384.17
  2. Los Angeles, CA · California$420.60+$36.43
  3. Washington, DC area · District of Columbia$430.72+$46.55
  4. Miami, FL · Florida$422.62+$38.45
  5. Chicago, IL · Illinois$411.02+$26.85
  6. Manhattan, NY · New York$438.52+$54.35
  7. Alaska · Alaska$459.65+$75.48

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

69610 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$346.15$230.12
ArkansasArkansas$341.64$227.73
ArizonaArizona$372.44$243.94
Bakersfield, CACalifornia$397.49$252.16
Chico, CACalifornia$395.69$250.36
El Centro, CACalifornia$395.79$250.46
Fresno, CACalifornia$395.69$250.36
Hanford, CACalifornia$395.69$250.36

69610 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.

$341.64

$459.65

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
69610 office rate range by state
State / territoryOffice rate rangeLocalities
AK$459.651
AL$346.151
AR$341.641
AZ$372.441
CA$395.69–$483.8929
CO$393.131
CT$405.981
DC$430.721
DE$378.151
FL$383.03–$422.623
GA$362.78–$390.162
GU$402.951
HI$402.951
IA$351.281
ID$353.931
IL$374.99–$411.024
IN$355.711
KS$351.121
KY$356.401
LA$356.42–$372.192
MA$391.67–$427.662
MD$384.45–$430.723
ME$357.02–$372.522
MI$366.01–$388.762
MN$373.781
MO$351.79–$371.793
MS$346.711
MT$382.061
NC$360.171
ND$369.811
NE$352.611
NH$388.361
NJ$409.79–$427.212
NM$368.361
NV$378.861
NY$365.17–$449.955
OH$363.501
OK$354.401
OR$375.09–$403.092
PA$363.27–$397.572
PR$384.171
RI$389.761
SC$362.601
SD$368.361
TN$352.881
TX$361.22–$392.558
UT$367.051
VA$372.35–$430.722
VI$384.171
VT$369.721
WA$390.49–$434.582
WI$358.711
WV$362.771
WY$376.721

See 69610 in every payment locality

How the 69610 rate is calculated

Each of 69610’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 · 69610

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.36

4.36 RVUs× 1.000 GPCI

Practice expense6.46

6.46 RVUs× 1.000 GPCI

Malpractice0.62

0.62 RVUs× 1.000 GPCI

Adjusted RVUs

11.4400

Conversion factor

$33.4009

Medicare rate

$382.11

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,623

Code
69610
Physician work
4.36
Practice expense
6.46
Malpractice
0.62

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 69610 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.36× 1.0004.3600
Practice expense6.46× 1.0116.5311
Malpractice0.62× 0.9850.6107
Total RVUs11.5018
Conversion factor× 33.4009

Office rate, Puerto Rico$384.17

Office: (4.36 × 1 + 6.46 × 1.011 + 0.62 × 0.985) × $33.4009 = $384.17

Facility: (4.36 × 1 + 2.49 × 1.011 + 0.62 × 0.985) × $33.4009 = $250.11

Open 69610 in the RVU calculator

Payment rules and modifiers for 69610

69610 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69610

Eardrum repair, patch or perforation preparation

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 69610

Eardrum repair, patch or perforation preparation

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

69610 without 50 · national office

$382.11

Eardrum repair, patch or perforation preparation

69610-50 · Bilateral: 150%

$573.17

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

Codes related to 69610

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

Codes related to 69610
CodeHow it relatesOffice range, Puerto Rico
Used instead
69620Myringoplasty, tympanic membrane perforationMyringoplasty is a separate choice when the documented repair fits that procedure's scope.$746.40
69631Tympanoplasty, no mastoidectomy or chain reconstructionTympanoplasty without mastoidectomy covers more extensive middle-ear work without ossicular chain reconstruction.No office rate
69632Tympanoplasty, without mastoidectomy, with ossicular reconstructionTympanoplasty without mastoidectomy includes ossicular chain reconstruction.No office rate

How 69610 has changed in Puerto Rico

69610 · Office / nonfacility

$384.17

Effective 2026-10-01

The base rate is $11.44 higher than on 2025-10-01, moving from $372.73 to $384.17 (3.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $372.73changed to$384.17

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.47 changed to 4.36
    • Practice expense RVU 6.38 changed to 6.46
    • Malpractice RVU 0.64 changed to 0.62
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $386.58changed to$372.73

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.45 changed to 6.38
    • Malpractice RVU 0.66 changed to 0.64

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $380.27changed to$386.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $393.47changed to$380.27

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.65 changed to 0.66
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $392.07changed to$393.47

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $396.99changed to$392.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.32 changed to 6.45
    • Malpractice RVU 0.64 changed to 0.65
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $392.55changed to$396.99

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.11 changed to 6.32
    • Malpractice RVU 0.63 changed to 0.64

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $389.33changed to$392.55

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.66 changed to 6.11
    • Malpractice RVU 0.62 changed to 0.63
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $391.52changed to$389.33

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.72 changed to 5.66
    • Malpractice RVU 0.64 changed to 0.62
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $391.09changed to$391.52

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $353.89changed to$391.09

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.81 changed to 5.72
    • Malpractice RVU 0.65 changed to 0.64
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $316.70changed to$353.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.94 changed to 5.81
    • Malpractice RVU 0.64 changed to 0.65
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $316.53changed to$316.70

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.88 changed to 5.94
    • Malpractice RVU 0.66 changed to 0.64

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $314.96changed to$316.53

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $314.55changed to$314.96

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.01 changed to 5.88
    • Malpractice RVU 0.56 changed to 0.66
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $310.02changed to$314.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.63 changed to 6.01
    • Malpractice RVU 0.59 changed to 0.56
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $310.02

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$384.17$250.11RVU26D
2026-07-01$384.17$250.11RVU26C
2026-04-01$384.17$250.11RVU26B
2026-01-01$384.17$250.11RVU26A
2025-10-01$372.73$280.88RVU25D
2025-07-01$372.73$280.88RVU25C
2025-04-01$372.73$280.88RVU25B
2025-01-01$372.73$280.88RVU25A
2024-10-01$386.58$289.03RVU24D
2024-07-01$386.58$289.03RVU24C
2024-04-01$386.58$289.03RVU24B
2024-03-09$386.58$289.03RVU24AR
2024-01-01$380.27$284.31RVU24A
2023-10-01$393.47$293.05RVU23D
2023-07-01$392.07$292.45RVU23C
2023-04-01$392.07$292.45RVU23B
2023-01-01$392.07$292.45RVU23A
2022-10-01$396.99$294.43RVU22D
2022-07-01$396.99$294.43RVU22C
2022-04-01$396.99$294.43RVU22B
2022-01-01$396.99$294.43RVU22A
2021-10-01$392.55$292.66RVU21D
2021-07-01$392.55$292.66RVU21C
2021-04-01$392.55$292.66RVU21B
2021-01-01$392.55$292.66RVU21A
2020-10-01$389.33$298.02RVU20D
2020-07-01$389.33$298.02RVU20C
2020-04-01$389.33$298.02RVU20B
2020-01-01$389.33$298.02RVU20A
2019-10-01$391.52$298.61RVU19D
2019-07-01$391.52$298.61RVU19C
2019-04-01$391.52$298.61RVU19B
2019-01-01$391.52$298.61RVU19A
2018-10-01$391.09$297.20RVU18D
2018-07-01$391.09$297.20RVU18C
2018-04-01$391.09$297.20RVU18B
2018-01-01$391.09$297.20RVU18AR1
2017-10-01$353.89$274.32RVU17D
2017-07-01$353.89$274.32RVU17C
2017-04-01$353.89$274.32RVU17B
2017-01-01$353.89$274.32RVU17A
2016-10-01$316.70$250.06RVU16D
2016-07-01$316.70$250.06RVU16C
2016-04-01$316.70$250.06RVU16B
2016-01-01$316.70$250.06RVU16A
2015-10-01$316.53$250.16RVU15D
2015-07-01$316.53$250.16RVU15C
2015-04-01$314.96$248.91RVU15B
2015-01-01$314.96$248.91RVU15A
2014-10-01$314.55$249.10RVU14D
2014-07-01$314.55$249.10RVU14C
2014-04-01$314.55$249.10RVU14B
2014-01-01$314.55$249.10RVU14A
2013-10-01$310.02$241.74RVU13D
2013-07-01$310.02$241.74RVU13C
2013-04-01$310.02$241.74RVU13B
2013-01-01$310.02$241.74RVU13AR

Price 69610 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

69610 billing questions

When is 69610 preferable to 69620?

Use 69610 for a limited tympanic membrane repair, such as perforation-margin preparation with or without a patch. 69620 represents myringoplasty and should be selected when the documented procedure meets that service’s scope.

Is patch placement separately reported?

No. Patch use is included in 69610, and site preparation may also be part of the repair.

How is bilateral repair reported?

Report modifier 50 for bilateral repair; CMS pays the bilateral procedure at 150%.

What documentation supports 69610 instead of tympanoplasty?

Document the tympanic membrane perforation and the limited repair performed, including site preparation and patch use when applicable. A more extensive procedure involving middle-ear reconstruction may point to a tympanoplasty code instead.

Are postoperative visits separately payable during the global period?

Related postoperative visits for 10 days are included in the procedure’s global period.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.

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 69610PPRRVU2026_Oct_nonQPP.csv, line 7,623 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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