CPT code 69970: Inner ear surgery, focal lesion removal2026 Medicare rate & RVUs in Illinois
Surgical removal of a focal lesion involving the inner-ear region, reported when the operative service is lesion excision rather than treatment of inner-ear function.
CMS doesn’t publish an office rate for 69970 in Illinois.
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 69970 covers
This service involves surgically removing a focal lesion involving the inner-ear region, often through an operation that requires exposure of the temporal bone or mastoid. It is typically performed by an otologist or neurotologist in a hospital operating room; complex skull-base cases may involve a neurosurgeon as well. The operative target is a lesion, not simply removal or destruction of inner-ear structures to treat a functional disorder.
Report the code when the operative report supports excision of an inner-ear lesion and describes its site, extent, and surgical work. A description of the approach and any mastoid or temporal-bone work helps distinguish lesion excision from a labyrinthectomy or nerve procedure. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; 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 69970 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $2,052.35 |
| East St. Louis, IL | Unavailable | $1,947.89 |
| Rest of Illinois | Unavailable | $1,874.02 |
| Suburban Chicago, IL | Unavailable | $1,985.74 |
How the 69970 rate is calculated
Each of 69970’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 · 69970
RVUs × geographic indexes × conversion factor
Work31.60
31.60 RVUs× 1.000 GPCI
Practice expense18.95
18.95 RVUs× 1.000 GPCI
Malpractice4.61
4.61 RVUs× 1.000 GPCI
Adjusted RVUs
55.1600
Conversion factor
$33.4009
Medicare rate
$1,842.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69970
69970 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69970
Inner ear surgery, focal lesion removal
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 69970
Inner ear surgery, focal lesion removal
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
69970 without 50 · national facility
$1,842.39
Inner ear surgery, focal lesion removal
69970-50 · Bilateral: 150%
$2,763.59
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).
69970 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 69905LabyrinthectomyTranscanal approach
- 69970 describes removal of a focal lesion. 69905 applies when the surgeon performs a labyrinthectomy rather than excising a lesion.
- 69910LabyrinthectomyMastoid approach
- Choose 69910 for inner-ear removal that includes mastoid work; choose 69970 when the documented service is focal lesion excision.
- 69949Inner ear procedureUnlisted procedure
- 69949 is the unlisted option for an inner-ear procedure without a specific listed code. Use 69970 when its defined lesion-removal service matches the operation.
- 69979Temporal bone surgeryUnlisted procedure
- 69979 covers an unlisted temporal-bone procedure. It is not the specific lesion-removal code when the operative service is described by 69970.
69970 billing questions
How is this distinguished from a labyrinthectomy?
This code is for removal of a focal lesion. A labyrinthectomy removes inner-ear structures; select the code that matches the operation actually performed and documented.
What operative documentation supports the code?
Document the lesion's location and extent, the structures involved, the approach, and the excision performed. Include related mastoid or temporal-bone work when present.
Can modifier 50 be reported for bilateral surgery?
Yes. CMS treats the procedure as bilateral with modifier 50 and pays it at 150%.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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