No office rate
Both include tympanoplasty with mastoidectomy; 69637 is distinguished by ossicular chain reconstruction, while 69635 is used without it.
On this page
CMS RVU26D · Effective 2026-10-01
69637 Tympanoplasty Medicare reimbursement rates in Alabama
Reports tympanic membrane and middle-ear reconstruction with mastoidectomy and ossicular chain reconstruction, typically for chronic ear disease requiring combined repair. Compare 69637 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 69637 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1163.90
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otolaryngology surgery
About 69637: Tympanoplasty with mastoidectomy and ossicular reconstruction
Reports tympanic membrane and middle-ear reconstruction with mastoidectomy and ossicular chain reconstruction, typically for chronic ear disease requiring combined repair.
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.
CMS billing rules for 69637
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.94 · 39%
- Practice expense (office) RVU21.34 · 55%
- Malpractice RVU2.18 · 6%
106
Medicare services in 2024 · #4839 by national volume
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.
69637 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
This is a neighboring tympanoplasty-with-mastoidectomy code. Compare the specific operative components documented with the applicable code descriptor before choosing between them.
No office rate
Both include ossicular chain reconstruction, but 69632 is for tympanoplasty without mastoidectomy; 69637 includes mastoidectomy.
Compare 69637 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$1163.90
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 69637 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
7,630
- Code
- 69637
- Physician work
- 14.94
- Practice expense
- 21.34
- Malpractice
- 2.18
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.94 | × 1.000 | 14.9400 |
| Practice expense | 21.34 | × 0.875 | 18.6725 |
| Malpractice | 2.18 | × 0.566 | 1.2339 |
| Total RVUs | 34.8464 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$1163.90
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.94 | 1 |
| Practice expense | 21.34 | 0.875 |
| Malpractice | 2.18 | 0.566 |
(14.94 × 1 + 21.34 × 0.875 + 2.18 × 0.566) × $33.4009 = $1163.90
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,62769633,,Rebuild eardrum structures,A,,12.00,14.38,NA,14.38,,1.86,28.24,28.24,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62869635,,Repair eardrum structures,A,,13.17,19.71,NA,19.71,,2.33,35.21,35.21,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62969636,,Rebuild eardrum structures,A,,15.04,21.37,NA,21.37,,2.19,38.60,38.60,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63069637,,Rebuild eardrum structures,A,,14.94,21.34,NA,21.34,,2.18,38.46,38.46,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63169641,,Revise middle ear & mastoid,A,,12.57,13.37,NA,13.37,,1.85,27.79,27.79,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63269642,,Revise middle ear & mastoid,A,,16.63,16.41,NA,16.41,,2.43,35.47,35.47,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63369643,,Revise middle ear & mastoid,A,,15.20,15.09,NA,15.09,,2.27,32.56,32.56,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515