Billing code 69601: Mastoid revisionMedicare rate & RVUs in Illinois
Reports revision of a previously operated mastoid when the surgeon completes the procedure to the extent of a complete mastoidectomy.
CMS doesn’t publish an office rate for 69601 in Illinois.
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 69601 covers
An otologist revises a mastoid that has undergone prior surgery and extends the work to a complete mastoidectomy. The operation addresses mastoid disease or anatomy requiring further surgical clearance; it is performed in an operating room, commonly in a hospital facility. The operative report should establish the prior mastoid procedure and describe the extent of the revision and the resulting complete mastoidectomy.
Select this code based on the operative result, not simply because the patient has a history of mastoid surgery. The related preoperative visit on the day before surgery and 90 days of related postoperative care are included in the 90-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure 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 69601 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $992.86 |
| East St. Louis | Unavailable | $937.57 |
| Rest Of Illinois | Unavailable | $905.98 |
| Suburban Chicago | Unavailable | $968.37 |
How the 69601 rate is calculated
Each of 69601’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 · 69601
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.11Practice expense 12.08Malpractice 1.91
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69601
69601 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69601
Mastoid revision
| 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 · 69601
Mastoid revision
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
69601 without 50 · national facility
$905.16
Mastoid revision
69601-50 · Bilateral: 150%
$1,357.74
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).
69601 compared with similar codes
Compare codes
69601 vs 69602 vs 69603 vs 69604 vs 69502: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69602Mastoid revision
- Use 69602 when the revision results in a modified radical mastoidectomy; 69601 identifies a complete mastoidectomy result.
- 69603Mastoid revision
- Use 69603 when the revision results in a radical mastoidectomy, rather than the complete mastoidectomy result represented by 69601.
- 69604Mastoid revision
- Use 69604 for a revision mastoidectomy resulting in tympanoplasty. Use 69601 when the documented result is a complete mastoidectomy.
- 69502Mastoidectomy
- 69502 describes a complete mastoidectomy without the revision context. Choose 69601 when the procedure revises a previously operated mastoid and results in a complete mastoidectomy.
69601 billing questions
How does this differ from 69602 or 69603?
Choose among these revision codes according to the extent of the resulting mastoidectomy: 69601 is the complete mastoidectomy outcome, while 69602 and 69603 represent modified radical and radical outcomes.
When is 69604 a better choice?
Use 69604 when the revision mastoidectomy results in tympanoplasty. For 69601, the documented result is a complete mastoidectomy.
What should the operative report establish?
Document the prior mastoid surgery, the revision performed, and the extent of the resulting mastoidectomy. The final operative result supports selection among the revision codes.
How is bilateral surgery reported?
For bilateral procedures reported with modifier 50, CMS pays this code at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when documentation supports medical necessity. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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 69601 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 →