2025 CPT code 69643
(Active) Effective Date: N/A Revision Date: N/A Surgery - Ear, Nose, and Throat Surgery Surgery Feed
Tympanoplasty with mastoidectomy; intact or reconstructed wall, without ossicular chain reconstruction.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 51 for multiple procedures, 59 for distinct procedural services). Consult the CPT manual for modifier usage guidelines.
Medical necessity for a 69643 procedure is established by the presence of a perforated tympanic membrane, chronic otitis media (middle ear infection), cholesteatoma, or other conditions causing significant hearing loss or risk of complications.The procedure must be deemed medically necessary by the attending physician.
The otolaryngologist (ENT surgeon) is responsible for performing the entire procedure, including surgical preparation, incision, mastoid removal, eardrum repair, canalplasty (if needed), and wound closure.Post-operative care is also the responsibility of the surgeon.
In simple words: This surgery repairs a hole in the eardrum and may also clean out and repair the bone behind the ear.It doesn't involve fixing the tiny bones inside the ear.
This procedure involves the surgical repair of the tympanic membrane (eardrum) and a mastoidectomy that preserves the posterior canal wall (either leaving it intact or reconstructing it if necessary).The procedure includes middle ear surgery, canalplasty (ear canal reconstruction if needed), and tympanic membrane repair.Reconstruction of the ossicular chain is explicitly excluded.
Example 1: A patient presents with a chronic middle ear infection and a perforated eardrum.The surgeon performs a 69643 procedure to repair the eardrum and remove infected bone. The posterior canal wall is left intact., A patient has a cholesteatoma (benign cyst) eroding the bone behind their eardrum.During the mastoidectomy, the posterior canal wall is partially removed to completely excise the cholesteatoma. The surgeon reconstructs this wall with cartilage during the same procedure., A patient has a perforated eardrum and a history of multiple ear infections resulting in scarring and adhesion formation.The surgeon performs a 69643, removing the adhesions, cleaning the middle ear, and repairing the eardrum.
Preoperative assessment including audiometry and imaging (CT scan), operative report detailing the procedure, including type of mastoidectomy, type of graft used (if any), and any complications. Post-operative audiometry.Pathology report if tissue is sent for analysis.
** The choice between 69643 and other similar codes (e.g., 69645) depends on whether the posterior canal wall is preserved or reconstructed and the extent of the mastoidectomy.Always refer to the most current CPT codebook for the most up-to-date information.
- Payment Status: Active
- Modifier TC rule: Not applicable.The 69643 code represents the complete procedure.
- Specialties:Otolaryngology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Office