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See a sample rate comparisonCPT 69635 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repair Eardrum Structures, Tympanoplasty With Antrotomy Or Mastoidotomy Including Canalplasty Atticotomy Middle Ear Surgery And Or Tympanic Membrane Repair Without Ossicular Chain Reconstruction
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Auditory System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 69635 |
| Medicaid Fee Schedule | View Medicaid rates for 69635 |
National average reimbursement for CPT 69635 by major payers:
$1,730.69
$1,584.42
$1,695.11
$2,046.46
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CPT 69635
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Brazoria, LLC
Memorial Hermann Surgery Center Brazoria LLC
$7,770.00Published ratePhysicians Surgery Center Of Tempe, LLC, Physicians Surgery Center Of Tempe
Physicians Surgery Center Of Tempe LLC
$5,249.00Published rateCapital Endoscopy LLC
Capital Endoscopy & Surgery Center
$3,486.00Published rateAasc, LLC, Atlanta Aesthetic Surgery Center
Surgery Center Of Atlanta
$1,604.00Published rateSouth Perry Endoscopy PLLC
$742.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 69635 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69635 code is part of the Surgery services used for Surgical Procedures on the Auditory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 69635 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 69620-CPT | Moderate | Myringoplasty Uncomplicated |
| 69632-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Repair The Eardrum And Reconstruct The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). The Procedure May Involve The Use Of A Full Or Partial Prosthesis For The Ossicular Chain. |
| 69635-CPT | High | Repair Eardrum Structures, Tympanoplasty With Antrotomy Or Mastoidotomy Including Canalplasty Atticotomy Middle Ear Surgery And Or Tympanic Membrane Repair Without Ossicular Chain Reconstruction |
| 69636-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Repair The Eardrum And Reconstruct The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). The Procedure May Involve The Use Of A Full Or Partial Prosthesis For The Ossicular Chain. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69635 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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