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Billing code 69637: TympanoplastyMedicare rate & RVUs

Reports tympanic membrane and middle-ear reconstruction with mastoidectomy and ossicular chain reconstruction, typically for chronic ear disease requiring combined repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities106 Medicare services in 2024

Medicare pays $1,284.60 for 69637 nationally in a facility.

Medicare rate · 69637

Tympanoplasty

Swap in your local Medicare rate.

Work RVUs
14.94
Total RVUs
38.46
Global days
090

National rate · 2026

$1,284.60

Facility setting, before claim adjustments.

See every locality for 69637 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 69637 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 69637 covers

An otolaryngologist reports this operation when tympanic membrane and middle-ear reconstruction is performed with mastoidectomy and reconstruction of the ossicular chain. It is used for selected cases of chronic middle-ear disease, including disease that damages the eardrum and hearing bones. The operation is generally performed in a hospital operating room, with the operative report documenting the ear treated and the reconstructive and mastoid work performed.

Select the code from the documented operative components, including mastoidectomy and ossicular chain reconstruction; distinguish it from tympanoplasty codes without mastoidectomy or without chain 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 the same 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 requires documented medical necessity; 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 69637 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

69637 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,163.90
Alaska*Unavailable$1,547.74
ArizonaUnavailable$1,252.02
ArkansasUnavailable$1,148.78
AtlantaUnavailable$1,312.14
AustinUnavailable$1,318.64
BakersfieldUnavailable$1,334.04
Baltimore/Surr. CntysUnavailable$1,361.87
BeaumontUnavailable$1,215.28
BrazoriaUnavailable$1,266.16

69637 rates by state

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

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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
69637 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

How the 69637 rate is calculated

Each of 69637’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 · 69637

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.94Practice expense 21.34Malpractice 2.18

38.4600 adjusted RVUs×$33.4009 conversion factor=$1,284.60

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 69637

69637 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69637

Tympanoplasty

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)0Not paid without supporting documentation.
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 · 69637

Tympanoplasty

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

69637 without 50 · national facility

$1,284.60

Tympanoplasty

69637-50 · Bilateral: 150%

$1,926.90

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

69637 compared with similar codes

Compare codes

69637 vs 69635 vs 69636 vs 69632: national Medicare rates

Swap in your local Medicare rate.

  • 69637
    Tympanoplasty · 14.94 wRVU
    —
  • 69635
    Tympanoplasty · 13.17 wRVU
    —
  • 69636
    Tympanoplasty · 15.04 wRVU
    —
  • 69632
    Tympanoplasty · 12.64 wRVU
    —

How to choose

69635Tympanoplasty
Both include tympanoplasty with mastoidectomy; 69637 is distinguished by ossicular chain reconstruction, while 69635 is used without it.
69636Tympanoplasty
This is a neighboring tympanoplasty-with-mastoidectomy code. Compare the specific operative components documented with the applicable code descriptor before choosing between them.
69632Tympanoplasty
Both include ossicular chain reconstruction, but 69632 is for tympanoplasty without mastoidectomy; 69637 includes mastoidectomy.

Codes related to 69637

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

Codes related to 69637
CodeHow it relatesNational office range
Same family
69636TympanoplastyA neighboring tympanoplasty and mastoidectomy code; compare the documented operative components.No office rate
69635TympanoplastyTympanoplasty with mastoidectomy but without ossicular chain reconstruction.No office rate
Used instead
69632TympanoplastyTympanoplasty with ossicular chain reconstruction when mastoidectomy is not performed.No office rate
69631TympanoplastyTympanoplasty without mastoidectomy or ossicular chain reconstruction.No office rate

69637 billing questions

What distinguishes 69637 from tympanoplasty codes without mastoidectomy?

This code includes mastoidectomy along with tympanic membrane and middle-ear reconstruction and ossicular chain reconstruction. Codes such as 69632 describe tympanoplasty with chain reconstruction without mastoidectomy.

Does the operative note need to document ossicular chain reconstruction?

Yes. The note should support reconstruction of the ossicular chain as well as the tympanoplasty and mastoidectomy performed.

Can a separate code be reported for the tympanic membrane repair?

The tympanic membrane repair is part of the combined operation described by this code. Do not separately report that same repair as a standalone service.

How is bilateral surgery reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150% when the procedure is performed bilaterally.

What postoperative care is included?

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

When is assistant-at-surgery payment allowed?

CMS allows assistant-at-surgery payment only when medical necessity is documented. 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
RVUs for 69637PPRRVU2026_Oct_nonQPP.csv, line 7,630 (RVU26D)

Open CMS sourceHow we calculate rates

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