$770.16
69610 is for a limited tympanic membrane repair, often involving site preparation or a patch. Choose 69620 when the procedure documented is myringoplasty.
On this page
CMS RVU26D · Effective 2026-10-01
69610 Eardrum repair Medicare reimbursement rates in Colorado
Reports a limited repair of a tympanic membrane perforation, such as edge preparation and patch placement, without more extensive middle-ear reconstruction. Compare 69610 office and facility rates across CMS payment localities in Colorado.
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 69610 in Colorado?
Colorado 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
$393.13
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$252.04
1 of 1 localities have a supported rate.
Payment area: Colorado
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
About 69610: Simple tympanic membrane repair
Reports a limited repair of a tympanic membrane perforation, such as edge preparation and patch placement, without more extensive middle-ear reconstruction.
An otolaryngologist uses this service for a limited repair of a tympanic membrane perforation, often by preparing the perforation margin and applying a patch. It is commonly performed in an office or outpatient setting for a persistent eardrum opening when a patch-based repair is appropriate. The service may include preparation of the perforation site; a patch may or may not be used.
Choose this code when the documented work is limited to the eardrum repair, rather than a more extensive tympanoplasty involving middle-ear reconstruction. The operative note should identify the perforation, the repair technique, and whether site preparation or a patch was used. Related postoperative visits during the 10-day global period are included. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. For bilateral repair, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 69610
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.36 · 38%
- Practice expense (office) RVU6.46 · 56%
- Malpractice RVU0.62 · 5%
2.7K
Medicare services in 2024 · #2245 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.
69610 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
69631 describes tympanoplasty without mastoidectomy and without ossicular chain reconstruction. It is a better fit when the operative work extends beyond a limited eardrum repair into middle-ear surgery.
No office rate
69632 is tympanoplasty without mastoidectomy with ossicular chain reconstruction. 69610 is limited to the tympanic membrane repair.
Compare 69610 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
Colorado →
Office / nonfacility
$393.13
Facility
$252.04
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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 69610 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,623
- Code
- 69610
- Physician work
- 4.36
- Practice expense
- 6.46
- Malpractice
- 0.62
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.36 | × 1.012 | 4.4123 |
| Practice expense | 6.46 | × 1.064 | 6.8734 |
| Malpractice | 0.62 | × 0.781 | 0.4842 |
| Total RVUs | 11.7700 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$393.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.36 | 1.012 |
| Practice expense | 6.46 | 1.064 |
| Malpractice | 0.62 | 0.781 |
(4.36 × 1.012 + 6.46 × 1.064 + 0.62 × 0.781) × $33.4009 = $393.13
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.36 | 1.012 |
| Practice expense | 2.49 | 1.064 |
| Malpractice | 0.62 | 0.781 |
(4.36 × 1.012 + 2.49 × 1.064 + 0.62 × 0.781) × $33.4009 = $252.04
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.
69610 billing questions
When is 69610 preferable to 69620?
Use 69610 for a limited tympanic membrane repair, such as perforation-margin preparation with or without a patch. 69620 represents myringoplasty and should be selected when the documented procedure meets that service’s scope.
Is patch placement separately reported?
No. Patch use is included in 69610, and site preparation may also be part of the repair.
How is bilateral repair reported?
Report modifier 50 for bilateral repair; CMS pays the bilateral procedure at 150%.
What documentation supports 69610 instead of tympanoplasty?
Document the tympanic membrane perforation and the limited repair performed, including site preparation and patch use when applicable. A more extensive procedure involving middle-ear reconstruction may point to a tympanoplasty code instead.
Are postoperative visits separately payable during the global period?
Related postoperative visits for 10 days are included in the procedure’s global period.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.
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.
7,62069602,,Rev mstdc rslt mod rad mstdc,A,,13.42,13.55,NA,13.55,,1.96,28.93,28.93,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62169603,,Revj mstdc rsltg rad mstdc,A,,13.85,19.32,NA,19.32,,2.02,35.19,35.19,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62269604,,Revj mstdc rsltg tympanplsty,A,,13.85,13.66,NA,13.66,,2.02,29.53,29.53,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62369610,,Tympanic membrane repair,A,,4.36,6.46,,2.49,,0.62,11.44,7.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62469620,,Myringoplasty,A,,5.88,15.44,,6.78,,0.87,22.19,13.53,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62569631,,Repair eardrum structures,A,,9.80,12.69,NA,12.69,,1.44,23.93,23.93,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62669632,,Rebuild eardrum structures,A,,12.64,14.47,NA,14.47,,1.91,29.02,29.02,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899