Billing code 69636: TympanoplastyMedicare rate & RVUs in Illinois
Reports tympanoplasty with radical or complete mastoidectomy and ossicular chain reconstruction for disease requiring extensive mastoid surgery and middle-ear reconstruction.
CMS doesn’t publish an office rate for 69636 in Illinois.
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 69636 covers
An otolaryngologist performs this operation to treat disease involving the middle ear and mastoid when the surgical plan includes radical or complete mastoidectomy and reconstruction of the ossicular chain. The work combines removal of diseased mastoid air cells with repair of the eardrum and restoration of sound-conducting structures. It is generally performed in an operating room, with the operative report documenting the extent of mastoid removal and the reconstruction performed.
Choose this code when the procedure includes both the radical or complete mastoidectomy and ossicular chain reconstruction; a less extensive mastoidectomy or tympanoplasty without chain reconstruction points to a different code in the family. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. An assistant is payable only when medical necessity is documented; 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.
Where 69636 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,391.09 |
| East St. Louis | Unavailable | $1,306.34 |
| Rest Of Illinois | Unavailable | $1,268.36 |
| Suburban Chicago | Unavailable | $1,368.53 |
How the 69636 rate is calculated
Each of 69636’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 · 69636
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.04Practice expense 21.37Malpractice 2.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69636
69636 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69636
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) | 0 | Not paid without supporting documentation. |
| 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 · 69636
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
69636 without 50 · national facility
$1,289.27
Tympanoplasty
69636-50 · Bilateral: 150%
$1,933.91
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).
69636 compared with similar codes
Compare codes
69636 vs 69635 vs 69632 vs 69633: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69635Tympanoplasty
- 69635 describes mastoidectomy with an intact or reconstructed canal wall and no ossicular chain reconstruction. 69637 includes chain reconstruction and radical or complete mastoidectomy.
- 69632Tympanoplasty
- 69632 includes ossicular chain reconstruction without mastoidectomy. Use 69637 when the operation also includes radical or complete mastoidectomy.
- 69633Tympanoplasty
- 69633 includes tympanoplasty with mastoidectomy but no ossicular chain reconstruction. 69637 includes chain reconstruction and radical or complete mastoidectomy.
69636 billing questions
How does 69637 differ from 69636?
Both include ossicular chain reconstruction with mastoidectomy. 69637 is for radical or complete mastoidectomy, while 69636 describes surgery with an intact or reconstructed canal wall.
When is 69637 appropriate instead of 69632?
69637 includes radical or complete mastoidectomy as well as ossicular chain reconstruction. 69632 is for tympanoplasty with chain reconstruction without mastoidectomy.
What should the operative report document?
Document the extent of mastoidectomy, the tympanoplasty performed, and the ossicular chain reconstruction. These details support choosing 69637 over less extensive mastoidectomy or non-reconstruction codes.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The operative documentation should support surgery on both sides.
Can an assistant or co-surgeon be billed?
An assistant at surgery is payable only with documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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