Billing code 69635: TympanoplastyMedicare rate & RVUs in Guam
Reports tympanic membrane repair performed with mastoidectomy when the operation does not include reconstruction of the ossicular chain.
CMS doesn’t publish an office rate for 69635 in Guam.
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 69635 covers
An otologic surgeon uses this code for tympanoplasty performed together with mastoidectomy, including associated canal and middle-ear work and repair of the tympanic membrane. The operation may be used for chronic middle-ear disease, such as disease involving the mastoid, when the surgeon repairs the eardrum but does not reconstruct the ossicular chain. It is typically performed in an operating room under anesthesia.
Choose this code when the operative report supports both tympanoplasty and mastoidectomy and documents no ossicular chain reconstruction; a tympanoplasty without mastoidectomy belongs to a different code family. The report should identify the treated ear, surgical extent, and whether the ossicles were reconstructed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with 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.
69635 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,233.47 |
How the 69635 rate is calculated
Each of 69635’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 · 69635
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.17Practice expense 19.71Malpractice 2.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69635
69635 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69635
Tympanoplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 0.07/0.79/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69635
Tympanoplasty
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69635 without 50 · national facility
$1,176.05
Tympanoplasty
69635-50 · Bilateral: 150%
$1,764.08
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).
69635 compared with similar codes
Compare codes
69635 vs 69631 vs 69636 vs 69610 vs 69620: national Medicare rates
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How to choose
- 69631Tympanoplasty
- Both involve tympanoplasty without ossicular chain reconstruction, but 69635 includes mastoidectomy and 69631 does not.
- 69636Tympanoplasty
- This code describes mastoidectomy tympanoplasty without ossicular chain reconstruction; 69636 is the sibling for cases that include ossicular chain reconstruction.
- 69610Eardrum repair
- 69610 is a tympanic membrane repair service. Choose 69635 when the operation also includes mastoidectomy and tympanoplasty.
- 69620Myringoplasty
- 69620 describes myringoplasty, rather than the mastoidectomy tympanoplasty reported with 69635.
69635 billing questions
How does this differ from 69631?
69635 includes mastoidectomy with tympanoplasty. 69631 is the tympanoplasty option without mastoidectomy.
When would 69636 be considered instead?
Use the applicable sibling code when the operation includes ossicular chain reconstruction. This code is for tympanoplasty with mastoidectomy without that reconstruction.
Can the eardrum repair and mastoidectomy be billed separately?
The tympanoplasty code includes the associated tympanic membrane repair and middle-ear work in the operation. Do not separately report those included elements as independent procedures.
What documentation supports reporting 69635?
The operative report should establish that tympanoplasty and mastoidectomy were performed, describe the surgical extent, and clarify that the ossicular chain was not reconstructed.
How are bilateral procedures and additional same-session procedures paid?
CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery 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
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