$190.76–$202.17
Both services include ventilating-tube placement. Choose 69436 for general anesthesia and 69433 for local or topical anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
69436 Tympanostomy Medicare reimbursement rates in Michigan
ENT surgeons report this service when they create an eardrum opening and place a ventilating tube under general anesthesia, typically for middle-ear disease. Compare 69436 office and facility rates across CMS payment localities in Michigan.
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 69436 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$139.76–$148.60
2 of 2 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.
Otolaryngology procedure
About 69436: Tympanostomy with tube under general anesthesia
ENT surgeons report this service when they create an eardrum opening and place a ventilating tube under general anesthesia, typically for middle-ear disease.
An otolaryngologist makes a small opening in the tympanic membrane and places a ventilating tube to help air reach the middle ear and fluid drain. The service is performed under general anesthesia, commonly for children with persistent middle-ear fluid or recurrent ear infections when ventilation is clinically indicated. It may be performed in a hospital outpatient department or ambulatory surgery setting, and may involve one or both ears.
Report this code when the procedure includes tube placement under general anesthesia; documentation should support the clinical indication, ear or ears treated, and tube insertion. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral treatment, modifier 50 is paid at 150%. An assistant at surgery is not paid, and co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 69436
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.96 · 45%
- Practice expense (office) RVU2.09 · 48%
- Malpractice RVU0.28 · 6%
11.4K
Medicare services in 2024 · #1407 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.
69436 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
This code includes a ventilating tube and is performed under general anesthesia; 69421 describes an eardrum incision without tube placement.
$121.99–$128.84
69424 is for removing a ventilating tube, not creating an eardrum opening and inserting one.
Compare 69436 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$148.60
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$139.76
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
69436 billing questions
How does this differ from 69433?
Both include placement of a ventilating tube. This code is for the procedure under general anesthesia; 69433 is used when it is performed under local or topical anesthesia.
Can this code be reported when no tube is placed?
No. This service includes tube placement. A myringotomy without a tube is represented by a different code, selected according to the anesthesia circumstance.
How is bilateral treatment reported?
Use modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be billed?
An assistant at surgery is not paid for this service. 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.
7,60369421,,Incision of eardrum,A,,1.74,2.14,NA,2.14,,0.25,4.13,4.13,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60469424,,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