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Billing code 69676: Tympanic neurectomyMedicare rate & RVUs

Report tympanic neurectomy when an otologic surgeon excises or divides a nerve in the middle ear as a distinct operative service.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $746.84 for 69676 nationally in a facility.

Medicare rate · 69676

Tympanic neurectomy

Swap in your local Medicare rate.

Work RVUs
9.45
Total RVUs
22.36
Global days
090

National rate · 2026

$746.84

Facility setting, before claim adjustments.

See every locality for 69676 → · 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 9 sections
  1. Medicare rate
  2. What 69676 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Billing questions
  9. Sources

What 69676 covers

This procedure removes or divides a nerve within the middle ear. It is typically performed by an otolaryngologist or otologist in an operating room, with surgical access to the middle ear. The operative report should identify the nerve treated and describe the neurectomy, rather than documenting only general middle-ear exposure or work on the eardrum, ossicles, or mastoid.

Report the code for the neurectomy itself, and document the treated side and any other procedures performed during the session. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 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 69676 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

69676 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$678.91
Alaska*Unavailable$909.34
ArizonaUnavailable$728.34
ArkansasUnavailable$670.42
AtlantaUnavailable$763.09
AustinUnavailable$764.67
BakersfieldUnavailable$772.11
Baltimore/Surr. CntysUnavailable$790.82
BeaumontUnavailable$708.90
BrazoriaUnavailable$735.90

69676 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
69676 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 69676 rate is calculated

Each of 69676’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 · 69676

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.45Practice expense 11.55Malpractice 1.36

22.3600 adjusted RVUs×$33.4009 conversion factor=$746.84

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

Payment rules and modifiers for 69676

69676 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69676

Tympanic neurectomy

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 · 69676

Tympanic neurectomy

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

69676 without 50 · national facility

$746.84

Tympanic neurectomy

69676-50 · Bilateral: 150%

$1,120.26

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

69676 compared with similar codes

Compare codes

69676 vs 69650 vs 69666 vs 69670: national Medicare rates

Swap in your local Medicare rate.

  • 69676
    Tympanic neurectomy · 9.45 wRVU
    —
  • 69650
    Stapes mobilization · 9.56 wRVU
    —
  • 69666
    Fistula repair · 9.64 wRVU
    —
  • 69670
    Mastoidectomy · 11.44 wRVU
    —

How to choose

69650Stapes mobilization
Code 69650 describes mobilization of the stapes. Use 69676 when the operative service is neurectomy of a middle-ear nerve.
69666Fistula repair
Code 69666 describes repair of a middle-ear structure. It represents repair work, not removal or division of a nerve.
69670Mastoidectomy
Code 69670 addresses removal of mastoid air cells. It is a mastoid procedure, unlike neurectomy within the middle ear.

69676 billing questions

How is this different from stapes surgery?

Tympanic neurectomy treats a middle-ear nerve. Code 69650 describes stapes mobilization, which addresses the stapes rather than nerve tissue.

Does the 90-day global period include postoperative care?

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

How should bilateral treatment be reported?

For bilateral treatment, report modifier 50; CMS pays the procedure at 150%.

What operative documentation supports this code?

Document the nerve treated, the side, and the excision or division performed. If other ear procedures were done in the same session, describe each separately.

Can an assistant or co-surgeon be reported?

CMS does not pay assistant-at-surgery services for this code. 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 69676PPRRVU2026_Oct_nonQPP.csv, line 7,644 (RVU26D)

Open CMS sourceHow we calculate rates

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