Billing code 69641: TympanoplastyMedicare rate & RVUs

Medicare pays $928.21 for 69641 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 69641 covers

An otolaryngologist, often a neurotologist, performs this operation to repair the tympanic membrane while operating on the mastoid and middle ear. It may be used for chronic ear disease, including cholesteatoma, when the surgical plan requires mastoidectomy along with tympanic membrane reconstruction. Canalplasty and related middle-ear work are included when performed as part of the service. The procedure is typically done in an operating room, such as a hospital or ambulatory surgery center.

Select the code from the operative work: tympanoplasty with mastoidectomy, with no ossicular chain reconstruction. The operative report should describe the tympanic membrane repair, mastoid work, middle-ear procedures, and whether the ossicular chain was reconstructed. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery services are not paid; 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 69641 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

69641 rates by state

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

How the 69641 rate is calculated

Each of 69641’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 69641

69641 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

69641 compared with similar codes

How to choose

69631Tympanoplasty

Choose 69631 for tympanoplasty without mastoidectomy. Choose 69641 when the operative service includes mastoidectomy.

69642Tympanoplasty

Both include tympanoplasty and mastoidectomy; 69642 includes ossicular chain reconstruction, while 69641 does not.

69643Tympanoplasty

69643 specifies an intact or reconstructed canal wall and no ossicular reconstruction. For 69641, select based on its operative scope rather than assuming that wall configuration.

69645Tympanoplasty

69645 is for tympanoplasty with radical or complete mastoidectomy and no ossicular reconstruction; 69641 describes a different mastoidectomy scope.

Codes related to 69641

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

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