CPT code 69631: Tympanoplasty, no mastoidectomy or chain reconstruction2026 Medicare rate & RVUs in North Carolina

In North Carolina, Medicare pays $753.52 for 69631 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 69631 nationwide

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

What 69631 covers

An otolaryngologist uses this operation to close a tympanic membrane perforation, commonly one that persists after infection or causes recurrent drainage or conductive hearing problems. The surgeon may use a graft such as fascia or cartilage. The work can include canalplasty, atticotomy, or middle-ear surgery as part of the tympanoplasty. The procedure is commonly performed in a hospital or ambulatory surgery center.

Select this code when the operative report supports tympanoplasty without mastoidectomy and without ossicular chain reconstruction. Document the perforation, surgical approach, graft or repair performed, and whether mastoid or ossicular-chain work was done. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 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.

How North Carolina compares for 69631

Across 109 of 109 payment localities, the facility rate for 69631 runs from $716.19 in Arkansas to $1,000.32 in San Benito County, CA. North Carolina pays $753.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

69631 rates by state

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

See 69631 in every payment locality

How the 69631 rate is calculated

Each of 69631’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.

Payment rules and modifiers for 69631

69631 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 69631

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

How 69631 has changed in North Carolina

Price 69631 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Advance
• Ahoskie
• Alamance
• Albemarle
• Alexis
• Alliance
• Altamahaw

Browse all communities in North Carolina

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

Open CMS sourceHow we calculate rates