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Billing code 69644: TympanoplastyMedicare rate & RVUs

Reports tympanoplasty with mastoidectomy, preservation or reconstruction of the ear canal wall, and reconstruction of the middle-ear ossicular chain.

CMS RVU26DEffective Oct 1, 2026109 payment localities417 Medicare services in 2024

Medicare pays $1,371.44 for 69644 nationally in a facility.

Medicare rate · 69644

Tympanoplasty

Work RVUs
16.8
Total RVUs
41.06
Global days
090

National rate · 2026

$1,371.44

Facility setting, before claim adjustments.

See every locality for 69644 →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 69644 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 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

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

109 of 109 payment localities

69644 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,244.76
Alaska*Unavailable$1,662.44
ArizonaUnavailable$1,337.04
ArkansasUnavailable$1,228.92
AtlantaUnavailable$1,401.29
AustinUnavailable$1,405.43
BakersfieldUnavailable$1,419.88
Baltimore/Surr. CntysUnavailable$1,453.05
BeaumontUnavailable$1,300.07
BrazoriaUnavailable$1,351.30

69644 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
69644 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 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

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)1Not paid (statutory restriction).
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 · 69644

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.

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

69644 without 50 · national facility

$1,371.44

Tympanoplasty

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).

When to use modifier 50

69644 compared with similar codes

Compare codes · National

4 codes, side by side

  • 69644

    Tympanoplasty16.8 wRVU

    Not priced

  • 69643

    Tympanoplasty15.2 wRVU

    Not priced

  • 69646

    Ear revision surgery17.91 wRVU

    Not priced

  • 69632

    Tympanoplasty12.64 wRVU

    Not priced

How to choose

69643Tympanoplasty
Both include mastoidectomy and an intact or reconstructed canal wall. 69644 includes ossicular chain reconstruction; 69643 does not.
69646Ear revision surgery
Both include ossicular chain reconstruction, but 69646 uses a canal-wall-down approach; 69644 preserves or reconstructs the canal wall.
69632Tympanoplasty
Both include ossicular chain reconstruction, but 69632 is tympanoplasty without mastoidectomy. 69644 includes mastoidectomy.

Codes related to 69644

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

Codes related to 69644
CodeHow it relatesNational office range
Same family
69643TympanoplastyIntact or reconstructed canal wall approach without ossicular chain reconstruction.No office rate
69646Ear revision surgeryCanal-wall-down approach with ossicular chain reconstruction.No office rate
69645TympanoplastyCanal-wall-down approach without ossicular chain reconstruction.No office rate
Used instead
69631TympanoplastyTympanoplasty without mastoidectomy or ossicular chain reconstruction.No office rate
69632TympanoplastyTympanoplasty without mastoidectomy, with ossicular chain reconstruction.No office rate

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
RVUs for 69644PPRRVU2026_Oct_nonQPP.csv, line 7,634 (RVU26D)

Open CMS sourceHow we calculate rates

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