Billing code 69666: Fistula repairMedicare rate & RVUs in Alabama
Reports operative closure of a leak at the oval window, typically when a perilymphatic fistula is identified during middle-ear surgery.
CMS doesn’t publish an office rate for 69666 in Alabama.
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 9 sections
What 69666 covers
An otologist or other otolaryngologist uses this code to repair a fistula at the oval window, the opening between the middle ear and inner ear. The procedure is generally performed in an operating room. A perilymph leak at this site may be associated with hearing symptoms or vertigo, including after trauma or prior ear surgery. The operative report should identify the oval window as the repair site and describe the fistula and its treatment.
Report the code for the oval-window repair itself, not for a leak at the round window or a procedure directed at stapes fixation. The service has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral repair, 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.
69666 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Unavailable | $656.78 |
How the 69666 rate is calculated
Each of 69666’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 · 69666
RVUs × geographic indexes × conversion factor
Work9.64
9.64 RVUs× 1.000 GPCI
Practice expense10.55
10.55 RVUs× 1.000 GPCI
Malpractice1.40
1.40 RVUs× 1.000 GPCI
Adjusted RVUs
21.5900
Conversion factor
$33.4009
Medicare rate
$721.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69666
69666 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69666
Fistula repair
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 69666
Fistula repair
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
69666 without 50 · national facility
$721.13
Fistula repair
69666-50 · Bilateral: 150%
$1,081.70
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).
69666 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 69667Window repair
- Both codes describe window fistula repair, but 69666 is specific to the oval window and 69667 to the round window. Use the documented repair site.
- 69660Stapes surgery
- 69660 describes surgery for stapes fixation. Use 69666 when the operative target is an oval-window fistula or leak.
- 69631Tympanoplasty
- 69631 is for tympanoplasty without mastoidectomy and without ossicular chain reconstruction. It is not the code for a specifically documented oval-window fistula repair.
- 69632Tympanoplasty
- 69632 describes tympanoplasty with ossicular chain reconstruction. Choose 69666 when the service is repair of an oval-window fistula rather than ossicular reconstruction.
69666 billing questions
How is this code distinguished from 69667?
69666 is for a fistula at the oval window; 69667 is for a fistula at the round window. The operative documentation should identify the repair site.
What should the operative report document?
Document the oval-window location, the fistula or leak found, and the repair performed. A general note of middle-ear exploration without the site and finding does not establish this specific service.
Is this the correct code for stapes fixation?
No. This code describes repair of an oval-window fistula. Stapes procedures such as 69660 address stapes fixation rather than closure of a fistula.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. For bilateral repair, modifier 50 is paid at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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
Fee sheets
Put 69666 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →