$204.80
69420 is a limited eardrum incision, commonly for drainage. Choose 69440 when the surgeon performs surgical inspection of the middle-ear space.
On this page
CMS RVU26D · Effective 2026-10-01
69440 Middle ear exploration Medicare reimbursement rates in Connecticut
Reports surgical inspection of middle-ear structures through a tympanotomy, often to investigate unexplained conductive hearing loss or suspected ossicular abnormality. Compare 69440 office and facility rates across CMS payment localities in Connecticut.
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 69440 in Connecticut?
Connecticut 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
$662.95
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 69440: Middle ear surgical exploration
Reports surgical inspection of middle-ear structures through a tympanotomy, often to investigate unexplained conductive hearing loss or suspected ossicular abnormality.
An otolaryngologist opens the tympanic membrane to inspect the middle-ear space and structures such as the ossicles. The procedure may be used when symptoms or examination findings, including unexplained conductive hearing loss or suspected ossicular abnormality, warrant direct surgical evaluation. It is generally performed in an operating room under anesthesia; it is more extensive than an eardrum incision for drainage or ventilation.
Report 69440 when the operative record supports middle-ear exploration, rather than a limited myringotomy or a tympanoplasty performed to reconstruct the tympanic membrane. Documentation should describe the indication, surgical approach, structures inspected, and any additional procedure performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Modifier 50 identifies bilateral performance and is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 69440
- 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
- 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 RVU7.52 · 40%
- Practice expense (office) RVU10.06 · 54%
- Malpractice RVU1.11 · 6%
243
Medicare services in 2024 · #4158 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.
69440 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$216.01
69433 represents tympanostomy with tube placement under its specified circumstances. It does not describe exploratory inspection of middle-ear structures.
No office rate
69631 describes tympanic membrane reconstruction without ossicular chain reconstruction. Use it for the reconstructive service rather than exploration alone.
No office rate
69632 describes tympanoplasty with ossicular chain reconstruction. It is distinguished from 69440 by the reconstructive work performed.
Compare 69440 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$662.95
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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 69440 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
7,607
- Code
- 69440
- Physician work
- 7.52
- Practice expense
- 10.06
- Malpractice
- 1.11
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.52 | × 1.020 | 7.6704 |
| Practice expense | 10.06 | × 1.077 | 10.8346 |
| Malpractice | 1.11 | × 1.210 | 1.3431 |
| Total RVUs | 19.8481 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$662.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.52 | 1.02 |
| Practice expense | 10.06 | 1.077 |
| Malpractice | 1.11 | 1.21 |
(7.52 × 1.02 + 10.06 × 1.077 + 1.11 × 1.21) × $33.4009 = $662.95
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.
69440 billing questions
How is 69440 different from a myringotomy?
69440 describes surgical inspection of the middle ear through a tympanotomy. A myringotomy is a limited eardrum incision, commonly for drainage or ventilation.
Can a tympanostomy tube be reported with 69440?
A tube procedure addresses middle-ear ventilation, while 69440 represents surgical exploration. The operative documentation must support each service, and same-session payment is subject to the multiple procedure reduction.
What documentation supports 69440?
Document the reason for exploration, the approach, and the middle-ear structures inspected. The record should distinguish exploration from a limited incision or a reconstructive tympanoplasty.
What global period applies?
69440 has a 90-day global period. The day-before preoperative visit and 90 days of related postoperative care are included.
How is bilateral performance reported?
Use modifier 50 for bilateral performance; CMS pays the procedure at 150% under the supplied fee schedule rule.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 69440. 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.
7,60469424,,Remove ventilating tube,A,,0.83,2.98,,0.74,,0.09,3.90,1.66,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60569433,,Create eardrum opening,A,,1.53,4.32,,1.84,,0.21,6.06,3.58,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60669436,,Create eardrum opening,A,,1.96,2.09,NA,2.09,,0.28,4.33,4.33,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60769440,,Exploration of middle ear,A,,7.52,10.06,NA,10.06,,1.11,18.69,18.69,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60869450,,Eardrum revision,A,,5.55,8.52,NA,8.52,,0.81,14.88,14.88,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60969501,,Mastoidectomy,A,,8.98,8.74,NA,8.74,,1.31,19.03,19.03,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61069502,,Mastoidectomy,A,,12.25,11.11,NA,11.11,,1.80,25.16,25.16,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808