No office rate
Choose 69806 when the labyrinthectomy is performed through a mastoid approach; 69805 identifies the transcanal approach.
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CMS RVU26D · Effective 2026-10-01
69806 Labyrinthectomy Medicare reimbursement rates in Colorado
Reports surgical ablation of the inner-ear labyrinth through a mastoid approach, typically for severe, disabling vertigo when sacrificing vestibular function is appropriate. Compare 69806 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 69806 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$829.65
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otology surgery
About 69806: Mastoid-approach labyrinthectomy
Reports surgical ablation of the inner-ear labyrinth through a mastoid approach, typically for severe, disabling vertigo when sacrificing vestibular function is appropriate.
An otologist or other ear surgeon uses a mastoid approach to reach and ablate the labyrinth, the inner-ear structure responsible for balance. The operation intentionally eliminates vestibular function on the treated side and may be considered for intractable vertigo, including selected patients with Ménière disease and nonserviceable hearing. It is performed in an operating room; the documented approach distinguishes it from a transcanal labyrinthectomy.
Report this code when the operative record supports labyrinthectomy performed through a mastoid approach, rather than medication perfusion or a transcanal operation. Documentation should identify the indication, treated side, surgical approach, and work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 69806
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.31 · 50%
- Practice expense (office) RVU10.33 · 42%
- Malpractice RVU1.78 · 7%
56
Medicare services in 2024 · #5291 by national volume
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.
69806 compared with similar codes
Office rates for Colorado, from the same CMS release.
$231.17
69801 involves inner-ear incision and perfusion of vestibuloactive medication. It does not describe surgical ablation of the labyrinth through a mastoid approach.
Compare 69806 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$829.65
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 69806 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,666
- Code
- 69806
- Physician work
- 12.31
- Practice expense
- 10.33
- Malpractice
- 1.78
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.31 | × 1.012 | 12.4577 |
| Practice expense | 10.33 | × 1.064 | 10.9911 |
| Malpractice | 1.78 | × 0.781 | 1.3902 |
| Total RVUs | 24.8390 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$829.65
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.31 | 1.012 |
| Practice expense | 10.33 | 1.064 |
| Malpractice | 1.78 | 0.781 |
(12.31 × 1.012 + 10.33 × 1.064 + 1.78 × 0.781) × $33.4009 = $829.65
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
69806 billing questions
How is this different from 69805?
This code is for labyrinthectomy through a mastoid approach. Code 69805 is the transcanal approach.
Can 69801 be used for the same treatment?
Code 69801 describes inner-ear incision with perfusion of vestibuloactive medication. It is a different intervention from surgical labyrinthectomy through a mastoid approach.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How should bilateral surgery be reported?
Use modifier 50 for bilateral reporting; CMS pays this code at 150% when reported bilaterally.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,66369799,,Unlisted px middle ear,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66469801,,Incise inner ear,A,,2.01,4.38,,0.92,,0.29,6.68,3.22,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66569805,,Explore inner ear,A,,14.34,10.72,NA,10.72,,2.09,27.15,27.15,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66669806,,Explore inner ear,A,,12.31,10.33,NA,10.33,,1.78,24.42,24.42,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66769905,,Remove inner ear,A,,10.98,11.92,NA,11.92,,1.61,24.51,24.51,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66869910,,Remove inner ear & mastoid,A,,13.56,10.63,NA,10.63,,1.98,26.17,26.17,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66969915,,Incise inner ear nerve,A,,22.20,13.75,NA,13.75,,3.23,39.18,39.18,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899