No office rate
69450 describes revision of the tympanic membrane. Use 69631 for tympanoplasty without mastoidectomy or ossicular chain reconstruction when that defined procedure is documented.
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CMS RVU26D · Effective 2026-10-01
69450 Eardrum revision Medicare reimbursement rates in Rhode Island
Surgical revision of a previously operated eardrum, such as repair of a persistent or recurrent perforation, reported when the documented work revises the membrane. Compare 69450 office and facility rates across CMS payment localities in Rhode Island.
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 69450 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$507.00
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 surgery
About 69450: Revision of the tympanic membrane
Surgical revision of a previously operated eardrum, such as repair of a persistent or recurrent perforation, reported when the documented work revises the membrane.
An otolaryngologist revises the tympanic membrane when a prior repair has not healed as intended or a defect has recurred. The operation addresses the membrane itself; a persistent or recurrent perforation after an earlier repair is a typical clinical situation. These procedures are generally performed in an operating room, including hospital outpatient and ambulatory surgery settings.
Report 69450 when the operative documentation supports revision of the eardrum, rather than an incision for drainage or ventilation or a different, more extensive tympanoplasty. The note should identify the treated side, prior membrane repair when relevant, the defect or problem addressed, and the revision performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 69450
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.55 · 37%
- Practice expense (office) RVU8.52 · 57%
- Malpractice RVU0.81 · 5%
144
Medicare services in 2024 · #4600 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.
69450 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$196.47
69420 is an eardrum incision for drainage or ventilation, not revision of a previously operated membrane.
No office rate
69440 describes exploration of the middle ear through an incision. It is not the code for revising the tympanic membrane itself.
Compare 69450 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
Unavailable
Facility
$507.00
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 69450 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,608
- Code
- 69450
- Physician work
- 5.55
- Practice expense
- 8.52
- Malpractice
- 0.81
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.55 | × 1.019 | 5.6554 |
| Practice expense | 8.52 | × 1.033 | 8.8012 |
| Malpractice | 0.81 | × 0.892 | 0.7225 |
| Total RVUs | 15.1791 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$507.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.55 | 1.019 |
| Practice expense | 8.52 | 1.033 |
| Malpractice | 0.81 | 0.892 |
(5.55 × 1.019 + 8.52 × 1.033 + 0.81 × 0.892) × $33.4009 = $507.00
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
69450 billing questions
How does 69450 differ from tympanoplasty?
Use 69450 when the documented service is revision of the tympanic membrane. Select the applicable tympanoplasty code when the operative report supports that more specifically defined procedure and extent.
Is 69450 used for a myringotomy or ear tube placement?
No. A myringotomy opens the eardrum, and tympanostomy involves placement of a ventilating tube; 69450 describes revision of the membrane.
What documentation supports 69450?
Document the side, the membrane problem being revised, relevant prior repair history, and the operative work performed.
How is bilateral treatment reported?
When both eardrums are revised, report the bilateral procedure with modifier 50; CMS pays it at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only with documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
7,60569433,,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
7,61069502,,Mastoidectomy,A,,12.25,11.11,NA,11.11,,1.80,25.16,25.16,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61169505,,Remove mastoid structures,A,,12.84,19.07,NA,19.07,,1.87,33.78,33.78,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537