Billing code 69801: Inner-ear perfusionMedicare rate & RVUs

Medicare pays $223.12 for 69801 nationally in the office and $107.55 in a hospital or facility. Local office rates run $197.79–$290.67.

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

What 69801 covers

This procedure uses a transcanal approach to reach the inner ear and deliver a vestibuloactive medication. Otologists commonly perform it for persistent vertigo associated with Ménière disease, including situations in which intratympanic medication is used to reduce vestibular function. The operative note should identify the treated ear, the medication and delivery method, and the clinical indication; documentation should support that the service involved inner-ear access and perfusion rather than a medication injection alone.

Report 69801 for the transcanal labyrinth perfusion, not for a destructive labyrinthectomy. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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. Bilateral reporting with modifier 50 is paid 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 69801 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

69801 rates by state

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

How the 69801 rate is calculated

Each of 69801’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.

Payment rules and modifiers for 69801

The CMS indicators that decide how 69801 is paid alongside other services.

What modifiers do to the payment

When to use modifier 50

69801 compared with similar codes

How to choose

69805Labyrinthectomy

Choose 69801 for transcanal medication perfusion. Code 69805 describes transcanal labyrinthectomy, which surgically destroys labyrinthine function.

69806Labyrinthectomy

Code 69806 describes labyrinthectomy through a transmastoid approach. It is not the transcanal medication-perfusion service represented by 69801.

69910Labyrinthectomy

Code 69910 describes vestibular nerve section through a transmastoid approach; 69801 involves transcanal inner-ear drug perfusion.

Codes related to 69801

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

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

Open CMS sourceHow we calculate rates