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Billing code 69511: Mastoid surgeryMedicare rate & RVUs

Reports radical mastoid surgery to eradicate extensive mastoid and middle-ear disease, such as cholesteatoma, when tympanoplasty is not part of the procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities29 Medicare services in 2024

Medicare pays $1,152.67 for 69511 nationally in a facility.

Medicare rate · 69511

Mastoid surgery

Swap in your local Medicare rate.

Work RVUs
13.36
Total RVUs
34.51
Global days
090

National rate · 2026

$1,152.67

Facility setting, before claim adjustments.

See every locality for 69511 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 69511 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 69511 covers

An otolaryngologist performs a radical mastoidectomy in the operating room to remove extensive disease involving the mastoid and middle ear and create an open surgical cavity. It is used for advanced chronic ear disease, including cholesteatoma, when the operative work is more extensive than a simple, complete, or modified radical mastoidectomy. Code 69511 distinguishes this operation from radical mastoidectomy performed with tympanoplasty.

Choose the code from the operative report’s documented extent and whether tympanoplasty was performed; the diagnosis alone does not establish the surgical level. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral surgery reported with modifier 50, payment is 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.

Where 69511 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

69511 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,044.24
Alaska*Unavailable$1,388.22
ArizonaUnavailable$1,123.41
ArkansasUnavailable$1,030.65
AtlantaUnavailable$1,177.36
AustinUnavailable$1,183.33
BakersfieldUnavailable$1,197.24
Baltimore/Surr. CntysUnavailable$1,222.06
BeaumontUnavailable$1,090.32
BrazoriaUnavailable$1,136.13

69511 rates by state

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

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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
69511 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 69511 rate is calculated

Each of 69511’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 · 69511

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.36Practice expense 19.20Malpractice 1.95

34.5100 adjusted RVUs×$33.4009 conversion factor=$1,152.67

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 69511

69511 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69511

Mastoid surgery

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 69511

Mastoid surgery

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

69511 without 50 · national facility

$1,152.67

Mastoid surgery

69511-50 · Bilateral: 150%

$1,729.01

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

69511 compared with similar codes

Compare codes

69511 vs 69505 vs 69502 vs 69530: national Medicare rates

Swap in your local Medicare rate.

  • 69511
    Mastoid surgery · 13.36 wRVU
    —
  • 69505
    Mastoidectomy · 12.84 wRVU
    —
  • 69502
    Mastoidectomy · 12.25 wRVU
    —
  • 69530
    Mastoid surgery · 19.87 wRVU
    —

How to choose

69505Mastoidectomy
69505 describes a modified radical mastoidectomy. Report 69511 when the operative work supports the more extensive radical procedure.
69502Mastoidectomy
69502 is for complete mastoidectomy; 69511 is for radical mastoid surgery involving a more extensive operation.
69530Mastoid surgery
Both describe radical mastoid surgery, but 69530 is the code to consider when tympanoplasty is performed with it.

Codes related to 69511

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

Codes related to 69511
CodeHow it relatesNational office range
Same family
69501MastoidectomySimple mastoidectomy; a less extensive operation in the mastoidectomy family.No office rate
69502MastoidectomyComplete mastoidectomy; distinguish its documented extent from radical surgery.No office rate
69505MastoidectomyModified radical mastoidectomy, generally less extensive than the radical operation.No office rate
Used instead
69530Mastoid surgeryRadical mastoidectomy when tympanoplasty is performed as part of the operation.No office rate

69511 billing questions

How is 69511 distinguished from a modified radical mastoidectomy?

69511 represents radical mastoid surgery, a more extensive operation than the modified radical mastoidectomy reported with 69505. Use the operative report to identify the actual extent performed.

When should 69530 be considered instead?

Use 69530 when the radical mastoidectomy is performed with tympanoplasty. Code 69511 describes radical mastoid surgery without that tympanoplasty distinction.

What documentation supports 69511?

The operative report should describe the disease treated, the extent of mastoid and middle-ear removal, and the creation of the surgical cavity. It should also make clear whether tympanoplasty was performed.

How is bilateral 69511 paid?

CMS pays bilateral surgery reported with modifier 50 at 150%.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

What postoperative care is included in the global period?

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

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 69511PPRRVU2026_Oct_nonQPP.csv, line 7,612 (RVU26D)

Open CMS sourceHow we calculate rates

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