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CPT code 69950: Vestibular nerve section, middle cranial fossa approach2026 Medicare rate & RVUs

Reports surgical interruption of the vestibular nerve through a middle cranial fossa approach, typically to treat severe, persistent vertigo while preserving hearing.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,511.06 for 69950 nationally in a facility.

Medicare rate · 69950

Vestibular nerve section, middle cranial fossa approach

Office or facility?

Work RVUs
26.94
Total RVUs
45.24
Global days
090

National rate · 2026

$1,511.06

Facility setting, before claim adjustments.

See every locality for 69950 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 69950 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 69950 covers

The surgeon reaches the vestibular portion of the eighth cranial nerve through the middle cranial fossa and interrupts its function to reduce vestibular signaling. Otologists, neurotologists, or surgeons working with a neurosurgical team may perform this operation for carefully selected patients with disabling vertigo that has not responded to less invasive treatment. The approach differs from nerve section performed through the ear canal and is intended to preserve cochlear function.

Report this code when the operative record supports vestibular nerve section by the middle cranial fossa route; the approach and nerve treated distinguish it from other inner-ear operations. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 69950 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

69950 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,394.09
AlaskaUnavailable$1,933.23
ArizonaUnavailable$1,477.28
ArkansasUnavailable$1,379.72
Atlanta, GAUnavailable$1,547.82
Austin, TXUnavailable$1,525.73
Bakersfield, CAUnavailable$1,522.91
Baltimore area, MDUnavailable$1,591.60
Beaumont, TXUnavailable$1,458.54
Brazoria, TXUnavailable$1,485.06

69950 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
69950 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 69950 rate is calculated

Each of 69950’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 · 69950

RVUs × geographic indexes × conversion factor

Office or facility?

Work26.94

26.94 RVUs× 1.000 GPCI

Practice expense14.37

14.37 RVUs× 1.000 GPCI

Malpractice3.93

3.93 RVUs× 1.000 GPCI

Adjusted RVUs

45.2400

Conversion factor

$33.4009

Medicare rate

$1,511.06

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 69950

69950 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69950

Vestibular nerve section, middle cranial fossa approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.07/0.79/0.14Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 69950

Vestibular nerve section, middle cranial fossa approach

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

69950 without 50 · national facility

$1,511.06

Vestibular nerve section, middle cranial fossa approach

69950-50 · Bilateral: 150%

$2,266.59

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).

When to use modifier 50

69950 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 69950

    Vestibular nerve section, middle cranial fossa approach26.94 wRVU

    Not priced

  • 69915

    Vestibular nerve section, transcanal approach22.2 wRVU

    Not priced

  • 69905

    Labyrinthectomy, transcanal approach10.98 wRVU

    Not priced

  • 69910

    Labyrinthectomy, mastoid approach13.56 wRVU

    Not priced

How to choose

69915Vestibular nerve sectionTranscanal approach
Choose 69950 for vestibular nerve section through the middle cranial fossa. Choose 69915 when the documented route is transcanal.
69905LabyrinthectomyTranscanal approach
69905 removes the labyrinth through a transcanal approach; 69950 interrupts the vestibular nerve through the middle cranial fossa.
69910LabyrinthectomyMastoid approach
69910 removes the labyrinth with mastoidectomy. It is not the nerve-section procedure reported with 69950.

Codes related to 69950

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 69950
CodeHow it relatesNational office range
Same family
69915Vestibular nerve section, transcanal approachVestibular nerve section through a transcanal approach rather than the middle cranial fossa.No office rate
Used instead
69905Labyrinthectomy, transcanal approachLabyrinth removal by a transcanal route is a different destructive operation for selected vertigo cases.No office rate
69910Labyrinthectomy, mastoid approachLabyrinth removal with mastoidectomy is a different operation, not vestibular nerve section.No office rate

69950 billing questions

How do I distinguish this from 69915?

Both codes describe vestibular nerve section, but 69950 is for the middle cranial fossa approach. Use 69915 for the transcanal approach.

Is the middle cranial fossa approach part of this code?

Yes. The documented approach is a key distinction for selecting 69950; do not treat it as a separate approach code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can I report an assistant or co-surgeon?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How is bilateral performance paid?

When the procedure is bilateral and reported with modifier 50, CMS pays it at 150%.

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
RVUs for 69950PPRRVU2026_Oct_nonQPP.csv, line 7,672 (RVU26D)

Open CMS sourceHow we calculate rates

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