Billing code 69436: TympanostomyMedicare rate & RVUs in Alaska
ENT surgeons report this service when they create an eardrum opening and place a ventilating tube under general anesthesia, typically for middle-ear disease.
CMS doesn’t publish an office rate for 69436 in Alaska.
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
What 69436 covers
An otolaryngologist makes a small opening in the tympanic membrane and places a ventilating tube to help air reach the middle ear and fluid drain. The service is performed under general anesthesia, commonly for children with persistent middle-ear fluid or recurrent ear infections when ventilation is clinically indicated. It may be performed in a hospital outpatient department or ambulatory surgery setting, and may involve one or both ears.
Report this code when the procedure includes tube placement under general anesthesia; documentation should support the clinical indication, ear or ears treated, and tube insertion. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same 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%. An assistant at surgery is not paid, and co-surgeon and team-surgery payment 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.
69436 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $177.70 |
How the 69436 rate is calculated
Each of 69436’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 · 69436
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.96Practice expense 2.09Malpractice 0.28
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69436
69436 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69436
Tympanostomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69436
Tympanostomy
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69436 without 50 · national facility
$144.63
Tympanostomy
69436-50 · Bilateral: 150%
$216.95
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).
69436 compared with similar codes
Compare codes
69436 vs 69433 vs 69421 vs 69424: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69433Ear tube placement
- Both services include ventilating-tube placement. Choose 69436 for general anesthesia and 69433 for local or topical anesthesia.
- 69421Myringotomy
- This code includes a ventilating tube and is performed under general anesthesia; 69421 describes an eardrum incision without tube placement.
- 69424Tube removal
- 69424 is for removing a ventilating tube, not creating an eardrum opening and inserting one.
69436 billing questions
How does this differ from 69433?
Both include placement of a ventilating tube. This code is for the procedure under general anesthesia; 69433 is used when it is performed under local or topical anesthesia.
Can this code be reported when no tube is placed?
No. This service includes tube placement. A myringotomy without a tube is represented by a different code, selected according to the anesthesia circumstance.
How is bilateral treatment reported?
Use modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be billed?
An assistant at surgery is not paid for this service. 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
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