No office rate
Both involve tympanoplasty without ossicular chain reconstruction, but 69635 includes mastoidectomy and 69631 does not.
On this page
CMS RVU26D · Effective 2026-10-01
69635 Tympanoplasty Medicare reimbursement rates in New Jersey
Reports tympanic membrane repair performed with mastoidectomy when the operation does not include reconstruction of the ossicular chain. Compare 69635 office and facility rates across CMS payment localities in New Jersey.
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 69635 in New Jersey?
New Jersey 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
$1261.76–$1314.38
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.
Otologic surgery
About 69635: Tympanoplasty with mastoidectomy, no ossicular reconstruction
Reports tympanic membrane repair performed with mastoidectomy when the operation does not include reconstruction of the ossicular chain.
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.
CMS billing rules for 69635
- 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 RVU13.17 · 37%
- Practice expense (office) RVU19.71 · 56%
- Malpractice RVU2.33 · 7%
123
Medicare services in 2024 · #4719 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.
69635 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
This code describes mastoidectomy tympanoplasty without ossicular chain reconstruction; 69636 is the sibling for cases that include ossicular chain reconstruction.
$409.79–$427.21
69610 is a tympanic membrane repair service. Choose 69635 when the operation also includes mastoidectomy and tympanoplasty.
$799.29–$838.03
69620 describes myringoplasty, rather than the mastoidectomy tympanoplasty reported with 69635.
Compare 69635 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
Northern Nj →
Office / nonfacility
Unavailable
Facility
$1314.38
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$1261.76
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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 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.
7,62569631,,Repair eardrum structures,A,,9.80,12.69,NA,12.69,,1.44,23.93,23.93,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62669632,,Rebuild eardrum structures,A,,12.64,14.47,NA,14.47,,1.91,29.02,29.02,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62769633,,Rebuild eardrum structures,A,,12.00,14.38,NA,14.38,,1.86,28.24,28.24,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62869635,,Repair eardrum structures,A,,13.17,19.71,NA,19.71,,2.33,35.21,35.21,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62969636,,Rebuild eardrum structures,A,,15.04,21.37,NA,21.37,,2.19,38.60,38.60,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63069637,,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