69620 Myringoplasty
What 69620 is
CMS fee schedule short descriptor: Myringoplasty.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 69620 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 5.88 | 15.44 | 0.87 | 22.19 | $741.17 |
| Facility (hospital, ASC) | 5.88 | 6.78 | 0.87 | 13.53 | $451.91 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 69620 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 69620? These codes are bundled into it
69620 is a Column 1 code in 248 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0583T | Tmpst auto tube dlvr sys | 1 - modifier may bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
Showing 30 of 248 column 2 codes. Use the pair checker for any specific combination.
69620 is bundled into these codes
69620 appears as a Column 2 code in 27 active edits. Reported with one of these Column 1 codes on the same date of service, 69620 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
69530 | Extensive mastoid surgery | 1 | Check pair |
69550 | Exc aurl glomus tum trnscanl | 1 | Check pair |
69552 | Exc aurl glomus tum trnsmstd | 1 | Check pair |
69554 | Exc aurl glomus tum extended | 1 | Check pair |
69604 | Revj mstdc rsltg tympanplsty | 1 | Check pair |
69631 | Repair eardrum structures | 1 | Check pair |
69632 | Rebuild eardrum structures | 1 | Check pair |
69633 | Rebuild eardrum structures | 1 | Check pair |
69635 | Repair eardrum structures | 1 | Check pair |
69636 | Rebuild eardrum structures | 1 | Check pair |
69637 | Rebuild eardrum structures | 1 | Check pair |
69641 | Revise middle ear & mastoid | 1 | Check pair |
69642 | Revise middle ear & mastoid | 1 | Check pair |
69643 | Revise middle ear & mastoid | 1 | Check pair |
69644 | Revise middle ear & mastoid | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.