Billing code 69801: Inner-ear perfusionMedicare rate & RVUs in Indiana
An otologist accesses the inner ear through the ear canal and perfuses a vestibuloactive drug, commonly to manage persistent vertigo from Ménière disease.
Medicare pays $207.46 for 69801 in the office in Indiana (Indiana). Which amount applies depends on the service address.
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 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.
69801 in Indiana
| Payment locality | Office | Facility |
|---|---|---|
| Indiana | $207.46 | $100.33 |
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.
How the rate is built · 69801
RVUs × geographic indexes × conversion factor
Work2.01
2.01 RVUs× 1.000 GPCI
Practice expense4.38
4.38 RVUs× 1.000 GPCI
Malpractice0.29
0.29 RVUs× 1.000 GPCI
Adjusted RVUs
6.6800
Conversion factor
$33.4009
Medicare rate
$223.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69801
The CMS indicators that decide how 69801 is paid alongside other services.
CMS payment indicators · 69801
Inner-ear perfusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69801 without 50 · national office
$223.12
Inner-ear perfusion
69801-50 · Bilateral: 150%
$334.68
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).
69801 compared with similar codes
Compare codes · National
4 codes, side by side
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.
69801 billing questions
How is 69801 different from a labyrinthectomy?
69801 describes transcanal inner-ear access with medication perfusion. Labyrinthectomy codes describe surgical destruction of labyrinthine function.
What documentation supports 69801?
Document the indication, treated ear, transcanal approach, and vestibuloactive medication perfused. The record should make clear that the service went beyond medication injection alone.
Does 69801 have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
How does Medicare handle 69801 with another procedure in the same session?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction and are paid at 50%.
Can 69801 be reported bilaterally?
CMS lists it as a bilateral procedure. Reporting modifier 50 results in payment at 150%.
When is an assistant-at-surgery paid for 69801?
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 69801 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 →