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Billing code 69535: Temporal bone surgeryMedicare rate & RVUs

Reports extensive temporal bone removal, generally for disease requiring resection beyond a mastoidectomy, performed by an otologic or skull-base surgeon.

CMS RVU26DEffective Oct 1, 2026109 payment localities184 Medicare services in 2024

Medicare pays $2,363.78 for 69535 nationally in a facility.

Medicare rate · 69535

Temporal bone surgery

Swap in your local Medicare rate.

Work RVUs
36.48
Total RVUs
70.77
Global days
090

National rate · 2026

$2,363.78

Facility setting, before claim adjustments.

See every locality for 69535 → · 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 69535 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 69535 covers

This operation removes temporal bone as part of an extensive ear or skull-base resection. The operative field may include the external auditory canal, middle ear, and mastoid, depending on the disease and planned extent. Otologists, neurotologists, and other surgeons experienced in skull-base procedures typically perform it in an operating room, often for destructive or malignant disease involving these structures. The operative report should identify the involved anatomy and describe the resection performed.

Select this code for the temporal bone resection itself, not simply because a mastoid operation is extensive. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery under the statutory restriction; co-surgeons require 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 69535 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

69535 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,165.81
Alaska*Unavailable$2,956.30
ArizonaUnavailable$2,308.24
ArkansasUnavailable$2,141.28
AtlantaUnavailable$2,418.57
AustinUnavailable$2,402.14
BakersfieldUnavailable$2,410.51
Baltimore/Surr. CntysUnavailable$2,495.97
BeaumontUnavailable$2,264.07
BrazoriaUnavailable$2,325.80

69535 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
69535 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 69535 rate is calculated

Each of 69535’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 · 69535

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 36.48Practice expense 28.98Malpractice 5.31

70.7700 adjusted RVUs×$33.4009 conversion factor=$2,363.78

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

Payment rules and modifiers for 69535

69535 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 69535

Temporal bone 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)1Not paid (statutory restriction).
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 · 69535

Temporal bone 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

69535 without 50 · national facility

$2,363.78

Temporal bone surgery

69535-50 · Bilateral: 150%

$3,545.67

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

69535 compared with similar codes

Compare codes

69535 vs 69511 vs 69530 vs 69552: national Medicare rates

Swap in your local Medicare rate.

  • 69535
    Temporal bone surgery · 36.48 wRVU
    —
  • 69511
    Mastoid surgery · 13.36 wRVU
    —
  • 69530
    Mastoid surgery · 19.87 wRVU
    —
  • 69552
    Aural tumor excision · 19.31 wRVU
    —

How to choose

69511Mastoid surgery
Use 69511 for radical mastoid surgery when the operative report supports that procedure. Use 69535 when the documented work is temporal bone resection.
69530Mastoid surgery
69530 describes an extensive mastoid operation; 69535 is for temporal bone removal. The operative anatomy and extent, not a general label of extensive surgery, distinguish them.
69552Aural tumor excision
69552 identifies transmastoid excision of an aural glomus tumor. 69535 describes temporal bone resection rather than that tumor- and approach-specific procedure.

Codes related to 69535

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

Codes related to 69535
CodeHow it relatesNational office range
Used instead
69511Mastoid surgeryConsider when the documented operation is radical mastoid surgery rather than temporal bone resection.No office rate
69530Mastoid surgeryAn extensive mastoid operation may fit when the operative work does not constitute temporal bone resection.No office rate
69552Aural tumor excisionA transmastoid glomus tumor excision is a tumor- and approach-specific alternative when that operation is performed.No office rate
69554Glomus tumor excisionAn extended-approach glomus tumor excision is reported when that defined operation is performed.No office rate

69535 billing questions

How is this different from a mastoidectomy code?

This code describes resection of temporal bone, potentially involving more than the mastoid. Choose a mastoidectomy code when the documented operation is a mastoid procedure rather than temporal bone resection.

What documentation supports reporting this code?

The operative report should establish the disease being treated and specify the temporal bone structures removed. It should make clear why the operation was a temporal bone resection rather than a mastoidectomy alone.

Is related postoperative care included?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery under the statutory restriction. Co-surgeons are paid only when supporting documentation is provided; team surgery is 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
RVUs for 69535PPRRVU2026_Oct_nonQPP.csv, line 7,614 (RVU26D)

Open CMS sourceHow we calculate rates

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