CPT code 69631: Tympanoplasty2026 Medicare rate & RVUs in Massachusetts
An otolaryngologist repairs a tympanic membrane, often for a persistent perforation, without mastoidectomy or ossicular chain reconstruction.
CMS doesn’t publish an office rate for 69631 in Massachusetts.
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 69631 covers
An otolaryngologist uses this operation to close a tympanic membrane perforation, commonly one that persists after infection or causes recurrent drainage or conductive hearing problems. The surgeon may use a graft such as fascia or cartilage. The work can include canalplasty, atticotomy, or middle-ear surgery as part of the tympanoplasty. The procedure is commonly performed in a hospital or ambulatory surgery center.
Select this code when the operative report supports tympanoplasty without mastoidectomy and without ossicular chain reconstruction. Document the perforation, surgical approach, graft or repair performed, and whether mastoid or ossicular-chain work was done. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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 69631 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | Unavailable | $889.64 |
| Rest Of Massachusetts | Unavailable | $817.22 |
How the 69631 rate is calculated
Each of 69631’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 · 69631
RVUs × geographic indexes × conversion factor
Work9.80
9.80 RVUs× 1.000 GPCI
Practice expense12.69
12.69 RVUs× 1.000 GPCI
Malpractice1.44
1.44 RVUs× 1.000 GPCI
Adjusted RVUs
23.9300
Conversion factor
$33.4009
Medicare rate
$799.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69631
69631 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69631
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 · 69631
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
69631 without 50 · national facility
$799.28
Tympanoplasty
69631-50 · Bilateral: 150%
$1,198.92
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).
69631 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 69632Tympanoplasty
- Both describe tympanoplasty without mastoidectomy; 69632 includes ossicular chain reconstruction, while 69631 does not.
- 69633Tympanoplasty
- This is the related tympanoplasty code when mastoidectomy is performed. Code 69631 is for tympanoplasty without mastoidectomy.
- 69610Eardrum repair
- Code 69610 describes tympanic membrane repair; 69631 represents tympanoplasty, which may include grafting and related middle-ear work.
- 69620Myringoplasty
- Myringoplasty is a distinct membrane-repair service. Choose 69631 when the operation is tympanoplasty without mastoidectomy or ossicular chain reconstruction.
69631 billing questions
How is this different from code 69632?
Code 69631 is for tympanoplasty without ossicular chain reconstruction. Use 69632 when the operation also reconstructs the ossicular chain.
Can canalplasty or atticotomy be separately reported?
These may be part of the tympanoplasty service described by this code. Do not report them separately when they are performed as part of that repair.
When would code 69610 be a better fit?
Code 69610 describes tympanic membrane repair rather than the more extensive tympanoplasty represented by 69631. The operative details should support which service was performed.
What documentation supports reporting 69631?
The operative report should identify the membrane perforation and repair, any graft used, and whether mastoidectomy or ossicular chain reconstruction was performed.
How is bilateral surgery reported under the CMS payment rule?
For bilateral procedures reported with modifier 50, CMS pays 150% under the supplied fee schedule rule.
What postoperative care is included?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
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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