No office rate
Both describe revision mastoid surgery, but 69601 represents a different resulting mastoid procedure. Choose the code that matches the operative result; 69604 is the tympanoplasty-resulting service.
On this page
CMS RVU26D · Effective 2026-10-01
69604 Mastoid revision Medicare reimbursement rates in Pennsylvania
Revision mastoid surgery that includes tympanoplasty is reported when an otologic surgeon revises a previously operated mastoid and repairs the eardrum. Compare 69604 office and facility rates across CMS payment localities in Pennsylvania.
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 69604 in Pennsylvania?
Pennsylvania 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
$945.20–$1026.38
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.
Otology surgery
About 69604: Revision mastoidectomy with tympanoplasty
Revision mastoid surgery that includes tympanoplasty is reported when an otologic surgeon revises a previously operated mastoid and repairs the eardrum.
An otolaryngologist, often an otologist, uses this code for revision surgery on a previously operated mastoid that includes tympanoplasty. The operation addresses the mastoid and reconstructs the tympanic membrane; it is performed in an operating room, commonly for persistent or recurrent disease in an ear with prior mastoid surgery. The operative report should make clear that this is revision work and describe both the mastoid portion and the eardrum repair.
Report the code when the revision results in tympanoplasty, rather than selecting a sibling code based on a different resulting mastoid procedure. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. 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 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 69604
- 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 RVU13.85 · 47%
- Practice expense (office) RVU13.66 · 46%
- Malpractice RVU2.02 · 7%
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.
69604 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
This is a sibling revision mastoidectomy code for a different resulting procedure. Use 69604 when the revision includes tympanoplasty as its result.
No office rate
69641 describes tympanoplasty performed with mastoidectomy; 69604 is for revision of a previously operated mastoid resulting in tympanoplasty.
No office rate
69631 is tympanoplasty without mastoidectomy. Choose 69604 when the operation includes revision mastoid work as well as tympanoplasty.
Compare 69604 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1026.38
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$945.20
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69604 billing questions
How does this differ from codes 69601 through 69603?
Those sibling codes represent revision mastoid procedures resulting in other specified mastoidectomy types. Use 69604 when the revision results in tympanoplasty.
Can tympanoplasty be reported separately from the mastoid revision?
The tympanoplasty is part of the service represented by 69604. Do not separately report the same eardrum repair work.
What documentation supports reporting 69604?
The operative report should describe the prior mastoid surgery, the revision performed, and the tympanoplasty completed as part of the operation.
How is bilateral surgery reported?
Use modifier 50 for bilateral reporting; CMS pays the bilateral procedure at 150%.
Is an assistant surgeon payable for this procedure?
CMS applies a statutory restriction, so an assistant at surgery is not paid for 69604. Co-surgeons and team surgery are also 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.
7,61969601,,Revj mstdc rsltg compl mstdc,A,,13.11,12.08,NA,12.08,,1.91,27.10,27.10,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62069602,,Rev mstdc rslt mod rad mstdc,A,,13.42,13.55,NA,13.55,,1.96,28.93,28.93,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62169603,,Revj mstdc rsltg rad mstdc,A,,13.85,19.32,NA,19.32,,2.02,35.19,35.19,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62269604,,Revj mstdc rsltg tympanplsty,A,,13.85,13.66,NA,13.66,,2.02,29.53,29.53,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62369610,,Tympanic membrane repair,A,,4.36,6.46,,2.49,,0.62,11.44,7.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62469620,,Myringoplasty,A,,5.88,15.44,,6.78,,0.87,22.19,13.53,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62569631,,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