CPT code 69666: Fistula repair, oval window2026 Medicare rate & RVUs in New Mexico
Reports operative closure of a leak at the oval window, typically when a perilymphatic fistula is identified during middle-ear surgery.
In New Mexico, Medicare pays $701.28 for 69666 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 69666 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 69666 covers
An otologist or other otolaryngologist uses this code to repair a fistula at the oval window, the opening between the middle ear and inner ear. The procedure is generally performed in an operating room. A perilymph leak at this site may be associated with hearing symptoms or vertigo, including after trauma or prior ear surgery. The operative report should identify the oval window as the repair site and describe the fistula and its treatment.
Report the code for the oval-window repair itself, not for a leak at the round window or a procedure directed at stapes fixation. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral repair, modifier 50 is paid 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.
How New Mexico compares for 69666
Across 109 of 109 payment localities, the facility rate for 69666 runs from $648.76 in Arkansas to $890.60 in San Benito County, CA. New Mexico pays $701.28. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$701.28
- Los Angeles, CA · California$783.10+$81.82
- Washington, DC area · District of Columbia$806.52+$105.24
- Miami, FL · Florida$807.07+$105.79
- Chicago, IL · Illinois$785.70+$84.42
- Manhattan, NY · New York$826.22+$124.94
- Alaska · Alaska$884.03+$182.75
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $656.78 |
| ArkansasArkansas | — | $648.76 |
| ArizonaArizona | — | $703.47 |
| Bakersfield, CACalifornia | — | $742.79 |
| Chico, CACalifornia | — | $738.73 |
| El Centro, CACalifornia | — | $738.96 |
| Fresno, CACalifornia | — | $738.73 |
| Hanford, CACalifornia | — | $738.73 |
| Madera, CACalifornia | — | $738.73 |
| Merced, CACalifornia | — | $738.73 |
| Modesto, CACalifornia | — | $738.73 |
| Napa, CACalifornia | — | $830.46 |
| Oxnard, CACalifornia | — | $776.65 |
| Redding, CACalifornia | — | $738.73 |
| Rest of CaliforniaCalifornia | — | $738.73 |
| Riverside, CACalifornia | — | $753.88 |
| Sacramento, CACalifornia | — | $768.46 |
| Salinas, CACalifornia | — | $765.44 |
| San Diego, CACalifornia | — | $778.43 |
| Marin County, CACalifornia | — | $870.89 |
| San Francisco, CACalifornia | — | $869.30 |
| San Benito County, CACalifornia | — | $890.60 |
| Santa Clara County, CACalifornia | — | $884.10 |
| San Luis Obispo, CACalifornia | — | $753.88 |
| Santa Cruz, CACalifornia | — | $781.95 |
| Santa Maria, CACalifornia | — | $766.94 |
| Santa Rosa, CACalifornia | — | $789.43 |
| Stockton, CACalifornia | — | $738.73 |
| Vallejo, CACalifornia | — | $828.17 |
| Visalia, CACalifornia | — | $738.73 |
| Yuba City, CACalifornia | — | $738.73 |
| ColoradoColorado | — | $737.30 |
| ConnecticutConnecticut | — | $764.52 |
| DelawareDelaware | — | $713.78 |
| Fort Lauderdale, FLFlorida | — | $763.49 |
| Rest of FloridaFlorida | — | $729.14 |
| Atlanta, GAGeorgia | — | $737.13 |
| Rest of GeorgiaGeorgia | — | $692.05 |
| Hawaii, Guam, HIHawaii | — | $749.71 |
| IowaIowa | — | $662.98 |
| IdahoIdaho | — | $668.29 |
| East St. Louis, ILIllinois | — | $740.35 |
| Rest of IllinoisIllinois | — | $716.80 |
| Suburban Chicago, ILIllinois | — | $768.99 |
| IndianaIndiana | — | $671.37 |
| KansasKansas | — | $664.10 |
| KentuckyKentucky | — | $678.04 |
| New Orleans, LALouisiana | — | $706.69 |
| Rest of LouisianaLouisiana | — | $678.64 |
| Metropolitan Boston, MAMassachusetts | — | $797.54 |
| Rest of MassachusettsMassachusetts | — | $735.46 |
| Baltimore area, MDMaryland | — | $763.08 |
| Rest of MarylandMaryland | — | $724.74 |
| Rest of MaineMaine | — | $675.26 |
| Southern Maine, MEMaine | — | $700.70 |
| Detroit, MIMichigan | — | $740.87 |
| Rest of MichiganMichigan | — | $696.50 |
| MinnesotaMinnesota | — | $698.42 |
| Metropolitan Kansas City, MOMissouri | — | $698.55 |
| Metropolitan St. Louis, MOMissouri | — | $704.30 |
| Rest of MissouriMissouri | — | $671.28 |
| MississippiMississippi | — | $659.94 |
| MontanaMontana | — | $721.03 |
| North CarolinaNorth Carolina | — | $680.64 |
| North DakotaNorth Dakota | — | $693.35 |
| NebraskaNebraska | — | $664.91 |
| New HampshireNew Hampshire | — | $729.73 |
| Northern New JerseyNew Jersey | — | $800.97 |
| Rest of New JerseyNew Jersey | — | $770.96 |
| NevadaNevada | — | $713.67 |
| NYC suburbs and Long Island, NYNew York | — | $848.41 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $778.91 |
| Queens, NYNew York | — | $826.53 |
| Rest of New YorkNew York | — | $689.62 |
| OhioOhio | — | $690.84 |
| OklahomaOklahoma | — | $672.99 |
| Portland, OROregon | — | $753.42 |
| Rest of OregonOregon | — | $705.83 |
| Metropolitan Philadelphia, PAPennsylvania | — | $750.39 |
| Rest of PennsylvaniaPennsylvania | — | $689.66 |
| Puerto RicoPuerto Rico | — | $724.30 |
| Rhode IslandRhode Island | — | $733.82 |
| South CarolinaSouth Carolina | — | $687.33 |
| South DakotaSouth Dakota | — | $690.08 |
| TennesseeTennessee | — | $667.41 |
| Austin, TXTexas | — | $736.88 |
| Beaumont, TXTexas | — | $686.09 |
| Brazoria, TXTexas | — | $710.24 |
| Dallas, TXTexas | — | $715.97 |
| Fort Worth, TXTexas | — | $713.06 |
| Galveston, TXTexas | — | $713.19 |
| Houston, TXTexas | — | $738.82 |
| Rest of TexasTexas | — | $698.62 |
| UtahUtah | — | $695.21 |
| VirginiaVirginia | — | $701.39 |
| Virgin Islands, VIUnited States Virgin Islands | — | $724.30 |
| VermontVermont | — | $694.50 |
| Rest of WashingtonWashington | — | $732.81 |
| King County, WAWashington | — | $808.66 |
| WisconsinWisconsin | — | $673.97 |
| West VirginiaWest Virginia | — | $695.12 |
| WyomingWyoming | — | $708.97 |
69666 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 69666 rate is calculated
Each of 69666’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 · 69666
RVUs × geographic indexes × conversion factor
Work9.64
9.64 RVUs× 1.000 GPCI
Practice expense10.55
10.55 RVUs× 1.000 GPCI
Malpractice1.40
1.40 RVUs× 1.000 GPCI
Adjusted RVUs
21.5900
Conversion factor
$33.4009
Medicare rate
$721.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,641
- Code
- 69666
- Physician work
- 9.64
- Practice expense
- 10.55
- Malpractice
- 1.40
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.64 | × 1.000 | 9.6400 |
| Practice expense | 10.55 | × 0.917 | 9.6744 |
| Malpractice | 1.40 | × 1.201 | 1.6814 |
| Total RVUs | 20.9958 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$701.28
Facility: (9.64 × 1 + 10.55 × 0.917 + 1.4 × 1.201) × $33.4009 = $701.28
Payment rules and modifiers for 69666
69666 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69666
Fistula repair, oval window
| 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 · 69666
Fistula repair, oval window
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
69666 without 50 · national facility
$721.13
Fistula repair, oval window
69666-50 · Bilateral: 150%
$1,081.70
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).
How 69666 has changed in New Mexico
69666 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $701.28 | RVU26D |
| 2026-07-01 | Not available in this setting | $701.28 | RVU26C |
| 2026-04-01 | Not available in this setting | $701.28 | RVU26B |
| 2026-01-01 | Not available in this setting | $701.28 | RVU26A |
| 2025-10-01 | Not available in this setting | $753.00 | RVU25D |
| 2025-07-01 | Not available in this setting | $753.00 | RVU25C |
| 2025-04-01 | Not available in this setting | $753.00 | RVU25B |
| 2025-01-01 | Not available in this setting | $753.00 | RVU25A |
| 2024-10-01 | Not available in this setting | $781.13 | RVU24D |
| 2024-07-01 | Not available in this setting | $781.13 | RVU24C |
| 2024-04-01 | Not available in this setting | $781.13 | RVU24B |
| 2024-03-09 | Not available in this setting | $781.13 | RVU24AR |
| 2024-01-01 | Not available in this setting | $768.38 | RVU24A |
| 2023-10-01 | Not available in this setting | $792.15 | RVU23D |
| 2023-07-01 | Not available in this setting | $792.15 | RVU23C |
| 2023-04-01 | Not available in this setting | $792.15 | RVU23B |
| 2023-01-01 | Not available in this setting | $792.15 | RVU23A |
| 2022-10-01 | Not available in this setting | $800.29 | RVU22D |
| 2022-07-01 | Not available in this setting | $800.29 | RVU22C |
| 2022-04-01 | Not available in this setting | $800.29 | RVU22B |
| 2022-01-01 | Not available in this setting | $800.29 | RVU22A |
| 2021-10-01 | Not available in this setting | $801.64 | RVU21D |
| 2021-07-01 | Not available in this setting | $801.64 | RVU21C |
| 2021-04-01 | Not available in this setting | $801.64 | RVU21B |
| 2021-01-01 | Not available in this setting | $801.64 | RVU21A |
| 2020-10-01 | Not available in this setting | $799.14 | RVU20D |
| 2020-07-01 | Not available in this setting | $799.14 | RVU20C |
| 2020-04-01 | Not available in this setting | $799.14 | RVU20B |
| 2020-01-01 | Not available in this setting | $799.14 | RVU20A |
| 2019-10-01 | Not available in this setting | $806.69 | RVU19D |
| 2019-07-01 | Not available in this setting | $806.69 | RVU19C |
| 2019-04-01 | Not available in this setting | $806.69 | RVU19B |
| 2019-01-01 | Not available in this setting | $806.69 | RVU19A |
| 2018-10-01 | Not available in this setting | $804.86 | RVU18D |
| 2018-07-01 | Not available in this setting | $804.86 | RVU18C |
| 2018-04-01 | Not available in this setting | $804.86 | RVU18B |
| 2018-01-01 | Not available in this setting | $804.86 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $810.27 | RVU17D |
| 2017-07-01 | Not available in this setting | $810.27 | RVU17C |
| 2017-04-01 | Not available in this setting | $810.27 | RVU17B |
| 2017-01-01 | Not available in this setting | $810.27 | RVU17A |
| 2016-10-01 | Not available in this setting | $810.04 | RVU16D |
| 2016-07-01 | Not available in this setting | $810.04 | RVU16C |
| 2016-04-01 | Not available in this setting | $810.04 | RVU16B |
| 2016-01-01 | Not available in this setting | $810.04 | RVU16A |
| 2015-10-01 | Not available in this setting | $812.24 | RVU15D |
| 2015-07-01 | Not available in this setting | $812.24 | RVU15C |
| 2015-04-01 | Not available in this setting | $808.19 | RVU15B |
| 2015-01-01 | Not available in this setting | $808.19 | RVU15A |
| 2014-10-01 | Not available in this setting | $802.64 | RVU14D |
| 2014-07-01 | Not available in this setting | $802.64 | RVU14C |
| 2014-04-01 | Not available in this setting | $802.64 | RVU14B |
| 2014-01-01 | Not available in this setting | $802.64 | RVU14A |
| 2013-10-01 | Not available in this setting | $798.76 | RVU13D |
| 2013-07-01 | Not available in this setting | $798.76 | RVU13C |
| 2013-04-01 | Not available in this setting | $798.76 | RVU13B |
| 2013-01-01 | Not available in this setting | $798.76 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
69666 billing questions
How is this code distinguished from 69667?
69666 is for a fistula at the oval window; 69667 is for a fistula at the round window. The operative documentation should identify the repair site.
What should the operative report document?
Document the oval-window location, the fistula or leak found, and the repair performed. A general note of middle-ear exploration without the site and finding does not establish this specific service.
Is this the correct code for stapes fixation?
No. This code describes repair of an oval-window fistula. Stapes procedures such as 69660 address stapes fixation rather than closure of a fistula.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. For bilateral repair, modifier 50 is paid at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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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