CPT code 69667: Window repair, round window fistula2026 Medicare rate & RVUs in Missouri
Reports operative closure of a round window fistula, typically performed by an otolaryngologist to seal a suspected perilymph leak in the middle ear.
CMS doesn’t publish an office rate for 69667 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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On this page 9 sections
What 69667 covers
An otolaryngologist, often an otologist or neurotologist, uses an operative approach through the ear canal to expose and seal a fistula at the round window. The procedure may address suspected perilymph leakage associated with hearing or balance symptoms, including after pressure-related injury. A graft or other sealing material may be placed over the defect. The service is generally performed in an operating room under surgical conditions.
Report this code when the operative work specifically repairs the round window fistula; the operative note should identify the site and describe the repair. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple procedure reduction. 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 69667 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 | $701.13 |
| Metropolitan St. Louis, MO | Unavailable | $706.93 |
| Rest of Missouri | Unavailable | $673.78 |
How the 69667 rate is calculated
Each of 69667’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 · 69667
RVUs × geographic indexes × conversion factor
Work9.65
9.65 RVUs× 1.000 GPCI
Practice expense10.58
10.58 RVUs× 1.000 GPCI
Malpractice1.44
1.44 RVUs× 1.000 GPCI
Adjusted RVUs
21.6700
Conversion factor
$33.4009
Medicare rate
$723.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69667
69667 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69667
Window repair, round window fistula
| 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 · 69667
Window repair, round window fistula
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
69667 without 50 · national facility
$723.80
Window repair, round window fistula
69667-50 · Bilateral: 150%
$1,085.70
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).
69667 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69666Fistula repairOval window
- This code is for a round window fistula; 69666 is for an oval window fistula. Use the documented repair site to distinguish them.
- 69631TympanoplastyNo mastoidectomy or chain reconstruction
- 69631 addresses tympanic membrane repair by tympanoplasty, not an isolated round window fistula repair.
- 69632TympanoplastyWithout mastoidectomy, with ossicular reconstruction
- 69632 is a tympanoplasty code that includes ossicular chain reconstruction; 69667 identifies repair at the round window.
69667 billing questions
How is 69667 distinguished from 69666?
69667 is for repair at the round window; 69666 is for repair at the oval window. The operative report should identify which window was repaired.
Does a suspected perilymph leak alone support reporting 69667?
The operative documentation should show that the surgeon repaired a fistula at the round window. A suspected leak without that documented repair does not establish the service.
Is the preoperative visit included in the global period?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How does Medicare handle bilateral repair?
For a bilateral procedure, modifier 50 is paid at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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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