CPT code 69643: Tympanoplasty, intact or rebuilt canal wall2026 Medicare rate & RVUs in Nevada
Report this operation for tympanic membrane repair with mastoid surgery when the canal wall is preserved or reconstructed and the ossicular chain is not rebuilt.
In Nevada, Medicare pays $1,075.38 for 69643 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 69643 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 69643 covers
An otolaryngologist typically performs this operation in an operating room for chronic middle-ear or mastoid disease, including cases requiring removal of diseased tissue and repair of a tympanic membrane defect. The procedure combines tympanoplasty with mastoid work; its distinguishing features are an intact or reconstructed ear canal wall and no ossicular chain reconstruction. Canalplasty and related middle-ear work may be part of the operation.
Select the code from the operative report: it should support the tympanoplasty and mastoidectomy, the canal-wall approach, and the absence of ossicular chain reconstruction. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. 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.
How Nevada compares for 69643
Across 109 of 109 payment localities, the facility rate for 69643 runs from $979.69 in Arkansas to $1,340.10 in Alaska. Nevada pays $1,075.38. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Nevada · this page$1,075.38
- Los Angeles, CA · California$1,175.11+$99.73
- Washington, DC area · District of Columbia$1,213.23+$137.85
- Miami, FL · Florida$1,224.13+$148.75
- Chicago, IL · Illinois$1,191.79+$116.41
- Manhattan, NY · New York$1,246.11+$170.73
- Alaska · Alaska$1,340.10+$264.72
Other areas in Nevada first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $991.62 |
| ArkansasArkansas | — | $979.69 |
| ArizonaArizona | — | $1,060.99 |
| Bakersfield, CACalifornia | — | $1,115.92 |
| Chico, CACalifornia | — | $1,109.37 |
| El Centro, CACalifornia | — | $1,109.75 |
| Fresno, CACalifornia | — | $1,109.37 |
| Hanford, CACalifornia | — | $1,109.37 |
| Madera, CACalifornia | — | $1,109.37 |
| Merced, CACalifornia | — | $1,109.37 |
| Modesto, CACalifornia | — | $1,109.37 |
| Napa, CACalifornia | — | $1,242.49 |
| Oxnard, CACalifornia | — | $1,164.90 |
| Redding, CACalifornia | — | $1,109.37 |
| Rest of CaliforniaCalifornia | — | $1,109.37 |
| Riverside, CACalifornia | — | $1,133.91 |
| Sacramento, CACalifornia | — | $1,152.78 |
| Salinas, CACalifornia | — | $1,148.23 |
| San Diego, CACalifornia | — | $1,166.83 |
| Marin County, CACalifornia | — | $1,301.39 |
| San Francisco, CACalifornia | — | $1,298.82 |
| San Benito County, CACalifornia | — | $1,330.98 |
| Santa Clara County, CACalifornia | — | $1,320.44 |
| San Luis Obispo, CACalifornia | — | $1,131.04 |
| Santa Cruz, CACalifornia | — | $1,171.38 |
| Santa Maria, CACalifornia | — | $1,150.24 |
| Santa Rosa, CACalifornia | — | $1,182.50 |
| Stockton, CACalifornia | — | $1,109.37 |
| Vallejo, CACalifornia | — | $1,238.78 |
| Visalia, CACalifornia | — | $1,109.37 |
| Yuba City, CACalifornia | — | $1,109.37 |
| ColoradoColorado | — | $1,109.28 |
| ConnecticutConnecticut | — | $1,152.42 |
| DelawareDelaware | — | $1,076.37 |
| Fort Lauderdale, FLFlorida | — | $1,155.35 |
| Rest of FloridaFlorida | — | $1,103.49 |
| Atlanta, GAGeorgia | — | $1,112.36 |
| Rest of GeorgiaGeorgia | — | $1,047.66 |
| Hawaii, Guam, HIHawaii | — | $1,124.66 |
| IowaIowa | — | $998.97 |
| IdahoIdaho | — | $1,007.25 |
| East St. Louis, ILIllinois | — | $1,124.09 |
| Rest of IllinoisIllinois | — | $1,086.37 |
| Suburban Chicago, ILIllinois | — | $1,163.23 |
| IndianaIndiana | — | $1,011.77 |
| KansasKansas | — | $1,001.54 |
| KentuckyKentucky | — | $1,025.14 |
| New Orleans, LALouisiana | — | $1,068.11 |
| Rest of LouisianaLouisiana | — | $1,026.39 |
| Metropolitan Boston, MAMassachusetts | — | $1,197.79 |
| Rest of MassachusettsMassachusetts | — | $1,106.98 |
| Baltimore area, MDMaryland | — | $1,150.42 |
| Rest of MarylandMaryland | — | $1,092.44 |
| Rest of MaineMaine | — | $1,018.55 |
| Southern Maine, MEMaine | — | $1,055.02 |
| Detroit, MIMichigan | — | $1,121.91 |
| Rest of MichiganMichigan | — | $1,053.46 |
| MinnesotaMinnesota | — | $1,048.77 |
| Metropolitan Kansas City, MOMissouri | — | $1,055.04 |
| Metropolitan St. Louis, MOMissouri | — | $1,063.49 |
| Rest of MissouriMissouri | — | $1,016.01 |
| MississippiMississippi | — | $997.69 |
| MontanaMontana | — | $1,087.38 |
| North CarolinaNorth Carolina | — | $1,026.39 |
| North DakotaNorth Dakota | — | $1,042.50 |
| NebraskaNebraska | — | $1,001.56 |
| New HampshireNew Hampshire | — | $1,098.72 |
| Northern New JerseyNew Jersey | — | $1,205.32 |
| Rest of New JerseyNew Jersey | — | $1,161.57 |
| New MexicoNew Mexico | — | $1,060.94 |
| NYC suburbs and Long Island, NYNew York | — | $1,280.26 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,174.18 |
| Queens, NYNew York | — | $1,245.27 |
| Rest of New YorkNew York | — | $1,039.81 |
| OhioOhio | — | $1,044.29 |
| OklahomaOklahoma | — | $1,016.70 |
| Portland, OROregon | — | $1,132.19 |
| Rest of OregonOregon | — | $1,063.00 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,131.97 |
| Rest of PennsylvaniaPennsylvania | — | $1,042.03 |
| Puerto RicoPuerto Rico | — | $1,091.94 |
| Rhode IslandRhode Island | — | $1,105.62 |
| South CarolinaSouth Carolina | — | $1,037.85 |
| South DakotaSouth Dakota | — | $1,037.19 |
| TennesseeTennessee | — | $1,006.56 |
| Austin, TXTexas | — | $1,109.14 |
| Beaumont, TXTexas | — | $1,036.79 |
| Brazoria, TXTexas | — | $1,070.38 |
| Dallas, TXTexas | — | $1,079.32 |
| Fort Worth, TXTexas | — | $1,075.27 |
| Galveston, TXTexas | — | $1,075.03 |
| Houston, TXTexas | — | $1,116.58 |
| Rest of TexasTexas | — | $1,054.47 |
| UtahUtah | — | $1,049.56 |
| VirginiaVirginia | — | $1,056.67 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,091.94 |
| VermontVermont | — | $1,045.04 |
| Rest of WashingtonWashington | — | $1,102.73 |
| King County, WAWashington | — | $1,213.46 |
| WisconsinWisconsin | — | $1,013.90 |
| West VirginiaWest Virginia | — | $1,054.19 |
| WyomingWyoming | — | $1,067.82 |
69643 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 69643 rate is calculated
Each of 69643’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 · 69643
RVUs × geographic indexes × conversion factor
Work15.20
15.20 RVUs× 1.000 GPCI
Practice expense15.09
15.09 RVUs× 1.000 GPCI
Malpractice2.27
2.27 RVUs× 1.000 GPCI
Adjusted RVUs
32.5600
Conversion factor
$33.4009
Medicare rate
$1,087.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Nevada inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,633
- Code
- 69643
- Physician work
- 15.20
- Practice expense
- 15.09
- Malpractice
- 2.27
GPCI2026.csv
73
- Locality
- Nevada
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.20 | × 1.000 | 15.2000 |
| Practice expense | 15.09 | × 1.001 | 15.1051 |
| Malpractice | 2.27 | × 0.833 | 1.8909 |
| Total RVUs | 32.1960 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada$1075.38
Facility: (15.2 × 1 + 15.09 × 1.001 + 2.27 × 0.833) × $33.4009 = $1075.38
Payment rules and modifiers for 69643
69643 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69643
Tympanoplasty, intact or rebuilt canal wall
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.07/0.79/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69643
Tympanoplasty, intact or rebuilt canal wall
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69643 without 50 · national facility
$1,087.53
Tympanoplasty, intact or rebuilt canal wall
69643-50 · Bilateral: 150%
$1,631.30
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).
How 69643 has changed in Nevada
69643 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,075.38 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,075.38 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,075.38 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,075.38 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,173.18 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,173.18 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,173.18 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,173.18 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,215.24 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,215.24 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,215.24 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,215.24 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,195.41 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,261.64 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,261.64 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,261.64 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,261.64 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,300.52 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,300.52 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,300.52 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,300.52 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,303.96 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,303.96 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,303.96 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,303.96 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,264.19 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,264.19 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,264.19 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,264.19 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,257.93 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,257.93 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,257.93 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,257.93 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,247.44 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,247.44 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,247.44 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,247.44 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,274.52 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,274.52 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,274.52 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,274.52 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,300.43 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,300.43 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,300.43 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,300.43 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,300.82 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,300.82 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,294.34 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,294.34 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,307.12 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,307.12 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,307.12 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,307.12 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,318.34 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Nevada rate applies
Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.
- Alamo
- Amargosa Valley
- Austin
- Baker
- Battle Mountain
- Beatty
- Beaverdam
- Bennett Springs
69643 billing questions
How does 69643 differ from 69641?
Both involve tympanoplasty with mastoidectomy without ossicular chain reconstruction. Choose 69643 when the canal wall is intact or reconstructed; the operative report should establish that feature.
When is 69644 reported instead?
Use 69644 when the canal wall is intact or reconstructed and the operation also includes ossicular chain reconstruction. Code 69643 describes the corresponding canal-wall approach without that reconstruction.
Can canalplasty or middle-ear work be reported separately?
Canalplasty and related middle-ear work may be included in this tympanoplasty-mastoidectomy service. The operative report should identify any separate procedure as distinct rather than an integral part of the operation.
What documentation supports 69643?
Document the tympanoplasty and mastoidectomy, whether the canal wall was preserved or reconstructed, and whether the ossicular chain was reconstructed. These details distinguish 69643 from nearby codes.
How does Medicare handle bilateral reporting and other procedures in the same session?
With modifier 50, a bilateral procedure is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
Is an assistant surgeon or co-surgeon payable?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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
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