No office rate
Choose 69631 for tympanoplasty without mastoidectomy. Choose 69641 when the operative service includes mastoidectomy.
On this page
CMS RVU26D · Effective 2026-10-01
69641 Tympanoplasty Medicare reimbursement rates in Wisconsin
Reports tympanic membrane reconstruction performed with mastoidectomy and middle-ear surgery when the surgeon does not reconstruct the ossicular chain. Compare 69641 office and facility rates across CMS payment localities in Wisconsin.
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 69641 in Wisconsin?
Wisconsin 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
$866.70
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 69641: Tympanoplasty with mastoidectomy, no ossicular reconstruction
Reports tympanic membrane reconstruction performed with mastoidectomy and middle-ear surgery when the surgeon does not reconstruct the ossicular chain.
An otolaryngologist, often a neurotologist, performs this operation to repair the tympanic membrane while operating on the mastoid and middle ear. It may be used for chronic ear disease, including cholesteatoma, when the surgical plan requires mastoidectomy along with tympanic membrane reconstruction. Canalplasty and related middle-ear work are included when performed as part of the service. The procedure is typically done in an operating room, such as a hospital or ambulatory surgery center.
Select the code from the operative work: tympanoplasty with mastoidectomy, with no ossicular chain reconstruction. The operative report should describe the tympanic membrane repair, mastoid work, middle-ear procedures, and whether the ossicular chain was reconstructed. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 69641
- 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 RVU12.57 · 45%
- Practice expense (office) RVU13.37 · 48%
- Malpractice RVU1.85 · 7%
368
Medicare services in 2024 · #3804 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.
69641 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
Both include tympanoplasty and mastoidectomy; 69642 includes ossicular chain reconstruction, while 69641 does not.
No office rate
69643 specifies an intact or reconstructed canal wall and no ossicular reconstruction. For 69641, select based on its operative scope rather than assuming that wall configuration.
No office rate
69645 is for tympanoplasty with radical or complete mastoidectomy and no ossicular reconstruction; 69641 describes a different mastoidectomy scope.
Compare 69641 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$866.70
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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 69641 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
7,631
- Code
- 69641
- Physician work
- 12.57
- Practice expense
- 13.37
- Malpractice
- 1.85
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.57 | × 1.000 | 12.5700 |
| Practice expense | 13.37 | × 0.958 | 12.8085 |
| Malpractice | 1.85 | × 0.308 | 0.5698 |
| Total RVUs | 25.9483 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$866.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.57 | 1 |
| Practice expense | 13.37 | 0.958 |
| Malpractice | 1.85 | 0.308 |
(12.57 × 1 + 13.37 × 0.958 + 1.85 × 0.308) × $33.4009 = $866.70
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.
69641 billing questions
How does this differ from 69631?
This code includes mastoidectomy with tympanoplasty. Code 69631 describes tympanoplasty without mastoidectomy.
When should 69642 be used instead?
Use 69642 when the surgeon also reconstructs the ossicular chain. Code 69641 applies when that reconstruction is not performed.
Are canalplasty and middle-ear work separately reported?
Canalplasty and middle-ear surgery performed as part of this tympanoplasty with mastoidectomy are included in the service.
How is bilateral surgery reported?
Report bilateral surgery with modifier 50 when applicable; CMS pays 150% of the single-side allowance.
What postoperative care is included?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
CMS does not pay for 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.
7,62869635,,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
7,63269642,,Revise middle ear & mastoid,A,,16.63,16.41,NA,16.41,,2.43,35.47,35.47,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,63369643,,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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,