69667 Window repair Medicare reimbursement rates in California

An otolaryngologist, often an otologist or neurotologist, uses an operative approach through the ear canal to expose and seal a fistula at the round window. The procedure may address suspected perilymph leakage associated with hearing or balance symptoms, including after pressure-related injury. A graft or other sealing material may be placed over the defect. The service is generally performed in an operating room under surgical conditions.

Report this code when the operative work specifically repairs the round window fistula; the operative note should identify the site and describe the repair. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard multiple procedure reduction. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.