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

An otolaryngologist repairs a tympanic membrane, often for a persistent perforation, without mastoidectomy or ossicular chain reconstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality3.1K Medicare services in 2024

In New Mexico, Medicare pays $773.77 for 69631 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$773.77Hospital or facility

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.

We’ll open 69631 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 69631 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 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 New Mexico 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. New Mexico pays $773.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

69631 in New Mexico vs other payment areas
  1. New Mexico · this page$773.77
  2. Los Angeles, CA · California$874.11+$100.34
  3. Washington, DC area · District of Columbia$897.84+$124.07
  4. Miami, FL · Florida$890.20+$116.43
  5. Chicago, IL · Illinois$865.98+$92.21
  6. Manhattan, NY · New York$917.08+$143.31
  7. Alaska · Alaska$968.90+$195.13

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

69631 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$725.43
ArkansasArkansas—$716.19
ArizonaArizona—$779.22
Bakersfield, CACalifornia—$827.39
Chico, CACalifornia—$823.22
El Centro, CACalifornia—$823.46
Fresno, CACalifornia—$823.22
Hanford, CACalifornia—$823.22

69631 rates by state

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

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
69631 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

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.

How the rate is built · 69631

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.80

9.80 RVUs× 1.000 GPCI

Practice expense12.69

12.69 RVUs× 1.000 GPCI

Malpractice1.44

1.44 RVUs× 1.000 GPCI

Adjusted RVUs

23.9300

Conversion factor

$33.4009

Medicare rate

$799.28

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,625

Code
69631
Physician work
9.80
Practice expense
12.69
Malpractice
1.44

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 69631 in New Mexico
ComponentRVULocality factorAdjusted
Physician work9.80× 1.0009.8000
Practice expense12.69× 0.91711.6367
Malpractice1.44× 1.2011.7294
Total RVUs23.1662
Conversion factor× 33.4009

Facility rate, New Mexico$773.77

Facility: (9.8 × 1 + 12.69 × 0.917 + 1.44 × 1.201) × $33.4009 = $773.77

Open 69631 in the RVU calculator

Payment rules and modifiers for 69631

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

CMS payment indicators · 69631

Tympanoplasty, no mastoidectomy or chain reconstruction

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 · 69631

Tympanoplasty, no mastoidectomy or chain reconstruction

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

69631 without 50 · national facility

$799.28

Tympanoplasty, no mastoidectomy or chain reconstruction

69631-50 · Bilateral: 150%

$1,198.92

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

How 69631 has changed in New Mexico

69631 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$773.77RVU26D
2026-07-01Not available in this setting$773.77RVU26C
2026-04-01Not available in this setting$773.77RVU26B
2026-01-01Not available in this setting$773.77RVU26A
2025-10-01Not available in this setting$824.31RVU25D
2025-07-01Not available in this setting$824.31RVU25C
2025-04-01Not available in this setting$824.31RVU25B
2025-01-01Not available in this setting$824.31RVU25A
2024-10-01Not available in this setting$856.62RVU24D
2024-07-01Not available in this setting$856.62RVU24C
2024-04-01Not available in this setting$856.62RVU24B
2024-03-09Not available in this setting$856.62RVU24AR
2024-01-01Not available in this setting$842.64RVU24A
2023-10-01Not available in this setting$870.26RVU23D
2023-07-01Not available in this setting$870.26RVU23C
2023-04-01Not available in this setting$870.26RVU23B
2023-01-01Not available in this setting$870.26RVU23A
2022-10-01Not available in this setting$877.64RVU22D
2022-07-01Not available in this setting$877.64RVU22C
2022-04-01Not available in this setting$877.64RVU22B
2022-01-01Not available in this setting$877.64RVU22A
2021-10-01Not available in this setting$881.38RVU21D
2021-07-01Not available in this setting$881.38RVU21C
2021-04-01Not available in this setting$881.38RVU21B
2021-01-01Not available in this setting$881.38RVU21A
2020-10-01Not available in this setting$870.33RVU20D
2020-07-01Not available in this setting$870.33RVU20C
2020-04-01Not available in this setting$870.33RVU20B
2020-01-01Not available in this setting$870.33RVU20A
2019-10-01Not available in this setting$879.65RVU19D
2019-07-01Not available in this setting$879.65RVU19C
2019-04-01Not available in this setting$879.65RVU19B
2019-01-01Not available in this setting$879.65RVU19A
2018-10-01Not available in this setting$872.50RVU18D
2018-07-01Not available in this setting$872.50RVU18C
2018-04-01Not available in this setting$872.50RVU18B
2018-01-01Not available in this setting$872.50RVU18AR1
2017-10-01Not available in this setting$877.66RVU17D
2017-07-01Not available in this setting$877.66RVU17C
2017-04-01Not available in this setting$877.66RVU17B
2017-01-01Not available in this setting$877.66RVU17A
2016-10-01Not available in this setting$882.50RVU16D
2016-07-01Not available in this setting$882.50RVU16C
2016-04-01Not available in this setting$882.50RVU16B
2016-01-01Not available in this setting$882.50RVU16A
2015-10-01Not available in this setting$882.97RVU15D
2015-07-01Not available in this setting$882.97RVU15C
2015-04-01Not available in this setting$878.58RVU15B
2015-01-01Not available in this setting$878.58RVU15A
2014-10-01Not available in this setting$874.53RVU14D
2014-07-01Not available in this setting$874.53RVU14C
2014-04-01Not available in this setting$874.53RVU14B
2014-01-01Not available in this setting$874.53RVU14A
2013-10-01Not available in this setting$875.29RVU13D
2013-07-01Not available in this setting$875.29RVU13C
2013-04-01Not available in this setting$875.29RVU13B
2013-01-01Not available in this setting$875.29RVU13AR

Price 69631 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

69631 billing questions

How is this different from code 69632?

Code 69631 is for tympanoplasty without ossicular chain reconstruction. Use 69632 when the operation also reconstructs the ossicular chain.

Can canalplasty or atticotomy be separately reported?

These may be part of the tympanoplasty service described by this code. Do not report them separately when they are performed as part of that repair.

When would code 69610 be a better fit?

Code 69610 describes tympanic membrane repair rather than the more extensive tympanoplasty represented by 69631. The operative details should support which service was performed.

What documentation supports reporting 69631?

The operative report should identify the membrane perforation and repair, any graft used, and whether mastoidectomy or ossicular chain reconstruction was performed.

How is bilateral surgery reported under the CMS payment rule?

For bilateral procedures reported with modifier 50, CMS pays 150%.

What postoperative care is included?

The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.

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 69631PPRRVU2026_Oct_nonQPP.csv, line 7,625 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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