CPT code 69644: Tympanoplasty, canal wall preserved, ossicles reconstructed2026 Medicare rate & RVUs in Louisiana
Reports tympanoplasty with mastoidectomy, preservation or reconstruction of the ear canal wall, and reconstruction of the middle-ear ossicular chain.
CMS doesn’t publish an office rate for 69644 in Louisiana.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 69644 covers
An otolaryngologist performs this operation to remove disease from the mastoid and middle ear, repair the eardrum, and reconstruct the ossicular chain while preserving or rebuilding the ear canal wall. It is commonly used for chronic middle-ear disease, including cholesteatoma, when surgery requires both mastoid work and restoration of the sound-conducting bones. The operation is generally performed in a surgical facility under anesthesia.
Select this code when the operative report supports mastoidectomy, tympanic membrane repair, ossicular chain reconstruction, and an intact or reconstructed canal wall. Documentation should describe the disease removed, the eardrum repair, the ossicular reconstruction, and the canal-wall approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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%. 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.
Where 69644 pays more and less in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | Unavailable | $1,339.66 |
| Rest of Louisiana | Unavailable | $1,284.25 |
How the 69644 rate is calculated
Each of 69644’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 · 69644
RVUs × geographic indexes × conversion factor
Work16.80
16.80 RVUs× 1.000 GPCI
Practice expense21.80
21.80 RVUs× 1.000 GPCI
Malpractice2.46
2.46 RVUs× 1.000 GPCI
Adjusted RVUs
41.0600
Conversion factor
$33.4009
Medicare rate
$1,371.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69644
69644 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69644
Tympanoplasty, canal wall preserved, ossicles reconstructed
| 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 · 69644
Tympanoplasty, canal wall preserved, ossicles reconstructed
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
69644 without 50 · national facility
$1,371.44
Tympanoplasty, canal wall preserved, ossicles reconstructed
69644-50 · Bilateral: 150%
$2,057.16
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).
69644 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69643TympanoplastyIntact or rebuilt canal wall
- Both include mastoidectomy and an intact or reconstructed canal wall. 69644 includes ossicular chain reconstruction; 69643 does not.
- 69646Ear revision surgeryMiddle ear and mastoid
- Both include ossicular chain reconstruction, but 69646 uses a canal-wall-down approach; 69644 preserves or reconstructs the canal wall.
- 69632TympanoplastyWithout mastoidectomy, with ossicular reconstruction
- Both include ossicular chain reconstruction, but 69632 is tympanoplasty without mastoidectomy. 69644 includes mastoidectomy.
69644 billing questions
How does this differ from 69643?
Both involve tympanoplasty with mastoidectomy and an intact or reconstructed canal wall. Report 69644 when the surgeon also reconstructs the ossicular chain; 69643 is the corresponding option without that reconstruction.
Is mastoidectomy separately reported with this code?
The mastoidectomy is part of the combined tympanoplasty service represented by 69644. The operative report should support the mastoid work and the associated eardrum and ossicular reconstruction.
When is 69646 a better choice?
Use 69646 for the related operation with a canal-wall-down approach and ossicular chain reconstruction. Code 69644 describes an intact or reconstructed canal wall.
How should bilateral surgery be reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The record should support surgery on both ears.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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