CPT code 69645: Tympanoplasty, complete mastoidectomy, no ossicular reconstruction2026 Medicare rate & RVUs in Oregon
Reports tympanic membrane and middle-ear repair performed with complete mastoidectomy when the surgeon does not reconstruct the ossicular chain.
CMS doesn’t publish an office rate for 69645 in Oregon.
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 69645 covers
An otolaryngologist uses this code for tympanoplasty combined with complete mastoidectomy, including associated work in the ear canal or middle ear. A typical clinical setting is surgery for chronic middle-ear disease or cholesteatoma involving the mastoid. The distinguishing feature is the extent of mastoid removal; ossicular chain reconstruction is not part of this service.
Choose the code from the operative report, which should support complete mastoidectomy and describe the tympanoplasty and middle-ear work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. CMS does not pay an assistant at surgery for this code; 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 69645 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | $1,419.31 |
| Rest of Oregon | Unavailable | $1,323.82 |
How the 69645 rate is calculated
Each of 69645’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 · 69645
RVUs × geographic indexes × conversion factor
Work16.29
16.29 RVUs× 1.000 GPCI
Practice expense21.73
21.73 RVUs× 1.000 GPCI
Malpractice2.42
2.42 RVUs× 1.000 GPCI
Adjusted RVUs
40.4400
Conversion factor
$33.4009
Medicare rate
$1,350.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69645
69645 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69645
Tympanoplasty, complete mastoidectomy, no ossicular reconstruction
| 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 · 69645
Tympanoplasty, complete mastoidectomy, no ossicular 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69645 without 50 · national facility
$1,350.73
Tympanoplasty, complete mastoidectomy, no ossicular reconstruction
69645-50 · Bilateral: 150%
$2,026.10
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).
69645 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69641TympanoplastyMastoidectomy, no ossicular reconstruction
- Both describe tympanoplasty with mastoidectomy without ossicular chain reconstruction. Choose 69645 when the operative report supports complete mastoidectomy.
- 69646Ear revision surgeryMiddle ear and mastoid
- Both include complete mastoidectomy; 69646 is the related variant that includes ossicular chain reconstruction.
- 69631TympanoplastyNo mastoidectomy or chain reconstruction
- 69631 describes tympanoplasty without mastoidectomy. Use 69645 when the surgeon also performs complete mastoidectomy.
69645 billing questions
How does 69645 differ from 69641?
69645 identifies tympanoplasty with complete mastoidectomy and no ossicular chain reconstruction. Use 69641 for the corresponding tympanoplasty-mastoidectomy service when the operative report does not support complete mastoidectomy.
Can 69645 be reported when the ossicular chain is reconstructed?
No. This code describes the service without ossicular chain reconstruction; select the applicable complete-mastoidectomy code that includes reconstruction when the surgeon performs it.
Does 69645 include tympanoplasty and mastoid work?
Yes. It represents the combined tympanoplasty and complete mastoidectomy service, including associated canal or middle-ear work described for the procedure.
How is bilateral surgery reported?
Report modifier 50 for bilateral surgery. CMS pays this bilateral procedure at 150%.
How does the multiple-procedure reduction affect 69645?
When multiple procedures are performed in the same session, CMS pays the highest-valued procedure in full and the other procedures at 50%.
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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