CPT code 69603: Mastoid revision, resulting in radical mastoidectomy2026 Medicare rate & RVUs in Missouri
Revision mastoid surgery reported when an earlier mastoidectomy is revised and the resulting operation creates a radical mastoidectomy.
CMS doesn’t publish an office rate for 69603 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 69603 covers
An otolaryngologist or otologist reports this service when revising a previously operated mastoid and the completed procedure results in a radical mastoidectomy. It is associated with complex ear disease, such as persistent or recurrent cholesteatoma, when the surgeon must revise the mastoid cavity and establish the radical surgical result. The operative report should describe the prior mastoid surgery, the work performed, and the resulting anatomy and extent of the revision.
Select this code based on the final operative result, not the diagnosis alone; a revision ending in a different mastoidectomy result belongs to a different code in the revision series. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented 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 69603 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 | $1,134.46 |
| Metropolitan St. Louis, MO | Unavailable | $1,144.54 |
| Rest of Missouri | Unavailable | $1,084.57 |
How the 69603 rate is calculated
Each of 69603’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 · 69603
RVUs × geographic indexes × conversion factor
Work13.85
13.85 RVUs× 1.000 GPCI
Practice expense19.32
19.32 RVUs× 1.000 GPCI
Malpractice2.02
2.02 RVUs× 1.000 GPCI
Adjusted RVUs
35.1900
Conversion factor
$33.4009
Medicare rate
$1,175.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69603
69603 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69603
Mastoid revision, resulting in radical mastoidectomy
| 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 · 69603
Mastoid revision, resulting in radical mastoidectomy
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
69603 without 50 · national facility
$1,175.38
Mastoid revision, resulting in radical mastoidectomy
69603-50 · Bilateral: 150%
$1,763.07
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).
69603 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69601Mastoid revisionComplete mastoidectomy result
- Use 69601 when the revision results in a complete mastoidectomy. This code is for a revision resulting in a radical mastoidectomy.
- 69602Mastoid revisionModified radical outcome
- Use 69602 when the revision results in a modified radical mastoidectomy; use 69603 for the radical mastoidectomy result.
- 69604Mastoid revisionResulting in tympanoplasty
- 69604 describes revision resulting in tympanoplasty. Choose 69603 when the documented revision results in a radical mastoidectomy.
69603 billing questions
What distinguishes this code from 69601 or 69602?
Choose among the revision codes according to the resulting mastoidectomy: 69601 represents a complete mastoidectomy result, 69602 a modified radical result, and 69603 a radical result.
How is 69603 distinguished from 69604?
Use 69603 when the revision results in a radical mastoidectomy. Use 69604 when the revision results in tympanoplasty instead.
What documentation supports reporting 69603?
Document the prior mastoid operation, the revision work performed, and the final surgical result establishing a radical mastoidectomy. The diagnosis by itself does not establish the appropriate revision code.
Does the 90-day global period include postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
When the procedure is performed bilaterally, modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
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
Show the CMS file lines behind this rate
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