CPT code 69511: Mastoid surgery, radical, without tympanoplasty2026 Medicare rate & RVUs in Missouri
Reports radical mastoid surgery to eradicate extensive mastoid and middle-ear disease, such as cholesteatoma, when tympanoplasty is not part of the procedure.
CMS doesn’t publish an office rate for 69511 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 69511 covers
An otolaryngologist performs a radical mastoidectomy in the operating room to remove extensive disease involving the mastoid and middle ear and create an open surgical cavity. It is used for advanced chronic ear disease, including cholesteatoma, when the operative work is more extensive than a simple, complete, or modified radical mastoidectomy. Code 69511 distinguishes this operation from radical mastoidectomy performed with tympanoplasty.
Choose the code from the operative report’s documented extent and whether tympanoplasty was performed; the diagnosis alone does not establish the surgical level. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 69511 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,112.05 |
| Metropolitan St. Louis, MO | Unavailable | $1,122.01 |
| Rest of Missouri | Unavailable | $1,062.47 |
How the 69511 rate is calculated
Each of 69511’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 69511
RVUs × geographic indexes × conversion factor
Work13.36
13.36 RVUs× 1.000 GPCI
Practice expense19.20
19.20 RVUs× 1.000 GPCI
Malpractice1.95
1.95 RVUs× 1.000 GPCI
Adjusted RVUs
34.5100
Conversion factor
$33.4009
Medicare rate
$1,152.67
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69511
69511 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69511
Mastoid surgery, radical, without tympanoplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.07/0.79/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69511
Mastoid surgery, radical, without tympanoplasty
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69511 without 50 · national facility
$1,152.67
Mastoid surgery, radical, without tympanoplasty
69511-50 · Bilateral: 150%
$1,729.01
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
69511 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69505MastoidectomyRadical procedure
- 69505 describes a modified radical mastoidectomy. Report 69511 when the operative work supports the more extensive radical procedure.
- 69502MastoidectomyComplete mastoid dissection
- 69502 is for complete mastoidectomy; 69511 is for radical mastoid surgery involving a more extensive operation.
- 69530Mastoid surgeryExtensive procedure
- Both describe radical mastoid surgery, but 69530 is the code to consider when tympanoplasty is performed with it.
69511 billing questions
How is 69511 distinguished from a modified radical mastoidectomy?
69511 represents radical mastoid surgery, a more extensive operation than the modified radical mastoidectomy reported with 69505. Use the operative report to identify the actual extent performed.
When should 69530 be considered instead?
Use 69530 when the radical mastoidectomy is performed with tympanoplasty. Code 69511 describes radical mastoid surgery without that tympanoplasty distinction.
What documentation supports 69511?
The operative report should describe the disease treated, the extent of mastoid and middle-ear removal, and the creation of the surgical cavity. It should also make clear whether tympanoplasty was performed.
How is bilateral 69511 paid?
CMS pays bilateral surgery reported with modifier 50 at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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