No office rate
This code is used for a revision mastoidectomy with the result specified by its descriptor. Compare that result with the middle-ear and mastoid revision documented for 69646.
On this page
CMS RVU26D · Effective 2026-10-01
69646 Ear revision surgery Medicare reimbursement rates in Rhode Island
Revision surgery involving the middle ear and mastoid is reported when an otolaryngologist reoperates on previously treated ear disease or surgical anatomy. Compare 69646 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 69646 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
$1457.23
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 69646: Revision middle ear and mastoid surgery
Revision surgery involving the middle ear and mastoid is reported when an otolaryngologist reoperates on previously treated ear disease or surgical anatomy.
CPT 69646 represents revision surgery involving the middle ear and mastoid, typically performed by an otolaryngologist or neurotologist in an operating room. The surgeon re-enters previously operated ear anatomy to address a persistent or recurrent problem, such as disease in a mastoid cavity or a failed prior middle-ear repair. The operative report should establish the prior surgery and describe the structures revised and the work performed; the diagnosis alone does not establish this code.
Report the code for the revision procedure actually performed, distinguishing it from a primary tympanoplasty or a mastoidectomy with a different documented result. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. For bilateral surgery, modifier 50 is paid at 150%. An assistant is paid only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.
CMS billing rules for 69646
- 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 RVU17.91 · 42%
- Practice expense (office) RVU22.21 · 52%
- Malpractice RVU2.73 · 6%
280
Medicare services in 2024 · #4047 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.
69646 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Choose 69603 when the operative result matches its radical mastoidectomy descriptor; 69646 is selected for its own documented revision procedure.
No office rate
69604 describes revision mastoidectomy resulting in tympanoplasty. Use 69646 only when the documented operation meets its distinct descriptor.
No office rate
69635 is a tympanoplasty with mastoidectomy code, rather than a general choice for revision work. Base selection on whether the operation is primary or revision and on the full procedure performed.
Compare 69646 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
$1457.23
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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 69646 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,636
- Code
- 69646
- Physician work
- 17.91
- Practice expense
- 22.21
- Malpractice
- 2.73
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.91 | × 1.019 | 18.2503 |
| Practice expense | 22.21 | × 1.033 | 22.9429 |
| Malpractice | 2.73 | × 0.892 | 2.4352 |
| Total RVUs | 43.6284 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1457.23
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.91 | 1.019 |
| Practice expense | 22.21 | 1.033 |
| Malpractice | 2.73 | 0.892 |
(17.91 × 1.019 + 22.21 × 1.033 + 2.73 × 0.892) × $33.4009 = $1457.23
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.
69646 billing questions
How is 69646 distinguished from a primary tympanoplasty?
Use 69646 for the documented revision involving previously operated middle-ear and mastoid anatomy. A primary tympanoplasty code describes a different operative circumstance; the operative report should support the revision work.
Can a separate mastoidectomy code also be reported?
Do not infer a separately reportable mastoidectomy from the fact that the revision involves the mastoid. Review the complete operative work and applicable CPT instructions before separately reporting another procedure.
What documentation supports reporting 69646?
Document the relevant prior ear surgery, the indication for reoperation, the middle-ear and mastoid anatomy addressed, and the specific revision performed.
How should bilateral surgery be reported?
For bilateral procedures, CMS pays this code at 150% when reported with modifier 50.
How does the global period affect postoperative visits?
The 90-day global includes the day-before preoperative visit and related postoperative care during the following 90 days.
Can an assistant or co-surgeon be billed?
An assistant at surgery is payable only with documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
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.
7,63369643,,Revise middle ear & mastoid,A,,15.20,15.09,NA,15.09,,2.27,32.56,32.56,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63469644,,Revise middle ear & mastoid,A,,16.80,21.80,NA,21.80,,2.46,41.06,41.06,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63569645,,Revise middle ear & mastoid,A,,16.29,21.73,NA,21.73,,2.42,40.44,40.44,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63669646,,Revise middle ear & mastoid,A,,17.91,22.21,NA,22.21,,2.73,42.85,42.85,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63769650,,Stapes mobilization,A,,9.56,10.53,NA,10.53,,1.39,21.48,21.48,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63869660,,Revise middle ear bone,A,,11.73,11.07,NA,11.07,,1.72,24.52,24.52,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63969661,,Revise middle ear bone,A,,15.52,14.09,NA,14.09,,2.26,31.87,31.87,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,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