CPT code 69642: Tympanoplasty, with mastoidectomy and reconstruction2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $1,321.46 for 69642 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 69642 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 69642 covers

An otolaryngologist performs this operation when disease or damage involves the tympanic membrane, middle ear, and mastoid, and the ossicular chain also requires reconstruction. The combined procedure includes mastoid work and tympanic membrane repair, with middle-ear surgery and canalplasty as needed. Typical cases involve chronic middle-ear disease or cholesteatoma with ossicular disruption; the operation is generally performed in a hospital or ambulatory surgery center.

Report 69642 when the operative service includes mastoidectomy and ossicular chain reconstruction. Distinguish it from tympanoplasty without mastoidectomy and from mastoid procedures without chain reconstruction; document the middle-ear and mastoid findings, the work performed, and the reconstruction. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. For bilateral surgery, 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 Washington, DC area compares for 69642

Across 109 of 109 payment localities, the facility rate for 69642 runs from $1,068.08 in Arkansas to $1,461.64 in Alaska. Washington, DC area pays $1,321.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

69642 rates by state

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

See 69642 in every payment locality

How the 69642 rate is calculated

Each of 69642’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 69642

69642 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 69642

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

How 69642 has changed in Washington, DC area

Price 69642 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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