CPT 69631 Surgery - Auditory

How Much Does Repair Eardrum Structures Cost?

Also known as: Repair eardrum structures (CPT 69631)

Tympanoplasty (eardrum repair surgery).

The total estimated cost of Repair Eardrum Structures (CPT 69631) is $2,686 to $5,036, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $799.

Total Estimated Cost of Care

$2,686 — $5,036

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$799
Hospital Facility Fee
$2,398
Anesthesia (est.)
$160
Important: The physician fee of $799 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$799
Physician component only — CMS PFS 2026

Patient Guide: Repair Eardrum Structures

What you need to know before your appointment

What to Expect

Under general anesthesia, the surgeon repairs a hole in the eardrum using tissue from your own body (often from behind the ear).

How Long Does It Take?

1-2 hours

Common Reasons Doctors Order This

Perforated eardrum, chronic ear infections, hearing loss from eardrum damage

How to Prepare

Fast before surgery. Keep the ear dry for 4-6 weeks after. Avoid nose-blowing for 2 weeks. Hearing improvement takes weeks to months.

Procedures Commonly Done Together

These procedures are frequently performed alongside Repair eardrum structures

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How to Reduce Your Cost for Repair eardrum structures

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

9.80
Work RVU
12.69
Practice Expense RVU
1.44
Malpractice RVU
23.93
Total RVU

Payment = Total RVU (23.93) x CF ($33.40) = $799

Frequently Asked Questions

How much does Repair eardrum structures cost?

The Medicare facility rate for Repair eardrum structures is $799. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Repair eardrum structures cost without insurance?

Without insurance, the cost of Repair eardrum structures can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Repair eardrum structures?

Most commercial health insurance plans and Medicare cover Repair eardrum structures when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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