CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 69610 RVU and Medicare Payment (2026)
Tympanic membrane repair — 4.36 work RVU, about $382.11 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 4.36
- PE RVU (non-facility)
- 6.46
- PE RVU (facility)
- 2.49
- MP RVU
- 0.62
- Office payment
- $382.11
- Facility payment
- $249.5
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 69610 in a non-facility setting with national GPCI: (4.36 + 6.46 + 0.62) × $33.4009 ≈ $382.11. The same code in a facility setting pays about $249.5 because facility PE RVU (2.49) replaces office PE RVU.
What changes by locality
GPCI moves 69610 non-facility payment from $341.64 to $483.89 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 69610?
4.36. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 69610 in 2026?
About $382.11 non-facility ($249.5 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (4.36) and malpractice RVU stay fixed; only practice expense changes (6.46 office vs 2.49 facility). That is the entire office-vs-facility payment gap.