No office rate
Use 69601 when the documented revision results in a complete mastoidectomy configuration; use 69602 for a modified radical result.
On this page
CMS RVU26D · Effective 2026-10-01
69602 Mastoid revision Medicare reimbursement rates in Kentucky
Reports revision of a previously operated mastoid, with the resulting surgical cavity reaching a modified radical configuration, commonly for persistent or recurrent ear disease. Compare 69602 office and facility rates across CMS payment localities in Kentucky.
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 69602 in Kentucky?
Kentucky 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
$910.49
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Otolaryngology surgery
About 69602: Revision mastoidectomy to modified radical extent
Reports revision of a previously operated mastoid, with the resulting surgical cavity reaching a modified radical configuration, commonly for persistent or recurrent ear disease.
An otolaryngologist revises a mastoid that has undergone prior surgery and extends the work to a modified radical configuration. This may be needed for persistent or recurrent disease, including cholesteatoma. The procedure is generally performed in an operating room; the operative findings and the completed surgical result distinguish it from a less extensive revision or a revision ending in a different mastoid configuration.
Report this code when the documented result is modified radical extent, not simply because the patient has had prior mastoid surgery. The operative report should identify the prior surgical site, the disease or findings addressed, and the extent and result of the revision. CMS assigns a 90-day global period, including 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 69602
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.42 · 46%
- Practice expense (office) RVU13.55 · 47%
- Malpractice RVU1.96 · 7%
41
Medicare services in 2024 · #5490 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.
69602 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Use 69603 when the revision results in a radical mastoidectomy configuration. The distinguishing endpoint for 69602 is modified radical extent.
No office rate
Use 69604 when the revision results in tympanoplasty. Select 69602 when the documented surgical result is a modified radical mastoid configuration.
Compare 69602 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$910.49
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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 69602 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,620
- Code
- 69602
- Physician work
- 13.42
- Practice expense
- 13.55
- Malpractice
- 1.96
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.42 | × 1.000 | 13.4200 |
| Practice expense | 13.55 | × 0.889 | 12.0460 |
| Malpractice | 1.96 | × 0.915 | 1.7934 |
| Total RVUs | 27.2593 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$910.49
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.42 | 1 |
| Practice expense | 13.55 | 0.889 |
| Malpractice | 1.96 | 0.915 |
(13.42 × 1 + 13.55 × 0.889 + 1.96 × 0.915) × $33.4009 = $910.49
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.
69602 billing questions
How is this code distinguished from 69601 or 69603?
Choose based on the documented result of the revision: this code indicates a modified radical configuration, while 69601 and 69603 represent complete and radical outcomes, respectively.
When is 69604 a better fit?
Use 69604 when the revision results in tympanoplasty. This code is for a revision whose documented result is a modified radical mastoid configuration.
What documentation supports reporting this code?
The operative report should establish prior mastoid surgery, describe the findings and work performed, and document that the revision resulted in modified radical extent.
Can both ears be reported?
For a bilateral procedure, CMS pays this code with modifier 50 at 150%. The operative documentation should support the procedure on both sides.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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.
7,61769552,,Exc aurl glomus tum trnsmstd,A,,19.31,20.65,NA,20.65,,2.82,42.78,42.78,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61869554,,Exc aurl glomus tum extended,A,,35.07,26.74,NA,26.74,,5.11,66.92,66.92,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61969601,,Revj mstdc rsltg compl mstdc,A,,13.11,12.08,NA,12.08,,1.91,27.10,27.10,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62069602,,Rev mstdc rslt mod rad mstdc,A,,13.42,13.55,NA,13.55,,1.96,28.93,28.93,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62169603,,Revj mstdc rsltg rad mstdc,A,,13.85,19.32,NA,19.32,,2.02,35.19,35.19,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62269604,,Revj mstdc rsltg tympanplsty,A,,13.85,13.66,NA,13.66,,2.02,29.53,29.53,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,62369610,,Tympanic membrane repair,A,,4.36,6.46,,2.49,,0.62,11.44,7.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631