No office rate
Both describe tympanoplasty with mastoidectomy without ossicular chain reconstruction. 69643 is distinguished by an intact or reconstructed canal wall.
On this page
CMS RVU26D · Effective 2026-10-01
69643 Tympanoplasty Medicare reimbursement rates in Maryland
Report this operation for tympanic membrane repair with mastoid surgery when the canal wall is preserved or reconstructed and the ossicular chain is not rebuilt. Compare 69643 office and facility rates across CMS payment localities in Maryland.
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 69643 in Maryland?
Maryland has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1092.44–$1213.23
3 of 3 localities have a supported rate.
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.
Where 69643 pays more and less in Maryland
Otolaryngology surgery
About 69643: Canal-wall tympanoplasty with mastoidectomy
Report this operation for tympanic membrane repair with mastoid surgery when the canal wall is preserved or reconstructed and the ossicular chain is not rebuilt.
An otolaryngologist typically performs this operation in an operating room for chronic middle-ear or mastoid disease, including cases requiring removal of diseased tissue and repair of a tympanic membrane defect. The procedure combines tympanoplasty with mastoid work; its distinguishing features are an intact or reconstructed ear canal wall and no ossicular chain reconstruction. Canalplasty and related middle-ear work may be part of the operation.
Select the code from the operative report: it should support the tympanoplasty and mastoidectomy, the canal-wall approach, and the absence of ossicular chain reconstruction. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 69643
- 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 RVU15.20 · 47%
- Practice expense (office) RVU15.09 · 46%
- Malpractice RVU2.27 · 7%
762
Medicare services in 2024 · #3198 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.
69643 compared with similar codes
Office rates for Maryland, from the same CMS release.
No office rate
This is the canal-wall counterpart when ossicular chain reconstruction is performed; 69643 is for the operation without that reconstruction.
No office rate
69631 describes tympanoplasty without mastoidectomy. Choose 69643 when mastoidectomy is part of the operation and the canal wall is intact or reconstructed.
Compare 69643 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.
3 of 3 payment localities
Baltimore/Surr. Cntys →
Office / nonfacility
Unavailable
Facility
$1150.42
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1213.23
Rest Of Maryland →
Office / nonfacility
Unavailable
Facility
$1092.44
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69643 billing questions
How does 69643 differ from 69641?
Both involve tympanoplasty with mastoidectomy without ossicular chain reconstruction. Choose 69643 when the canal wall is intact or reconstructed; the operative report should establish that feature.
When is 69644 reported instead?
Use 69644 when the canal wall is intact or reconstructed and the operation also includes ossicular chain reconstruction. Code 69643 describes the corresponding canal-wall approach without that reconstruction.
Can canalplasty or middle-ear work be reported separately?
Canalplasty and related middle-ear work may be included in this tympanoplasty-mastoidectomy service. The operative report should identify any separate procedure as distinct rather than an integral part of the operation.
What documentation supports 69643?
Document the tympanoplasty and mastoidectomy, whether the canal wall was preserved or reconstructed, and whether the ossicular chain was reconstructed. These details distinguish 69643 from nearby codes.
How does Medicare handle bilateral reporting and other procedures in the same session?
With modifier 50, a bilateral procedure is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
Is an assistant surgeon or co-surgeon payable?
Medicare 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 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.
7,63069637,,Rebuild eardrum structures,A,,14.94,21.34,NA,21.34,,2.18,38.46,38.46,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63169641,,Revise middle ear & mastoid,A,,12.57,13.37,NA,13.37,,1.85,27.79,27.79,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63269642,,Revise middle ear & mastoid,A,,16.63,16.41,NA,16.41,,2.43,35.47,35.47,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63369643,,Revise middle ear & mastoid,A,,15.20,15.09,NA,15.09,,2.27,32.56,32.56,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63469644,,Revise middle ear & mastoid,A,,16.80,21.80,NA,21.80,,2.46,41.06,41.06,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63569645,,Revise middle ear & mastoid,A,,16.29,21.73,NA,21.73,,2.42,40.44,40.44,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63669646,,Revise middle ear & mastoid,A,,17.91,22.21,NA,22.21,,2.73,42.85,42.85,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00