No office rate
Use 69805 for the transcanal approach. Use 69806 when the labyrinthectomy is performed with mastoidectomy.
On this page
CMS RVU26D · Effective 2026-10-01
69805 Labyrinthectomy Medicare reimbursement rates in Maine
Transcanal labyrinthectomy removes vestibular labyrinth structures to control severe unilateral vertigo when a destructive inner-ear operation is selected. Compare 69805 office and facility rates across CMS payment localities in Maine.
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 69805 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$851.80–$877.85
2 of 2 localities have a supported rate.
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.
Otologic surgery
About 69805: Transcanal labyrinthectomy
Transcanal labyrinthectomy removes vestibular labyrinth structures to control severe unilateral vertigo when a destructive inner-ear operation is selected.
An otologist or neurotologist performs this operation through the ear canal to ablate the labyrinth, the inner-ear structures responsible for balance. It may be considered for disabling, persistent vertigo, such as in selected patients with Ménière disease when hearing in the affected ear is already nonserviceable and less destructive treatment has not controlled symptoms. The procedure is generally performed in an operating room and intentionally sacrifices remaining labyrinthine function; hearing may also be lost.
Report this code for the transcanal approach, rather than a labyrinthectomy performed with mastoidectomy. The operative report should identify the approach, side, labyrinthine work, and clinical indication. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 applies to bilateral reporting, paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 69805
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.34 · 53%
- Practice expense (office) RVU10.72 · 39%
- Malpractice RVU2.09 · 8%
72
Medicare services in 2024 · #5130 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.
69805 compared with similar codes
Office rates for Maine, from the same CMS release.
$207.75–$218.23
Code 69801 is for labyrinthotomy with vestibuloactive drug perfusion, rather than destructive removal of labyrinthine structures.
Compare 69805 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$851.80
Southern Maine →
Office / nonfacility
Unavailable
Facility
$877.85
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69805 billing questions
How is this code distinguished from 69806?
This code describes the transcanal approach. Code 69806 is the labyrinthectomy performed with mastoidectomy; the operative report should support the approach used.
When would 69801 be considered instead?
Code 69801 describes transcanal labyrinthotomy with perfusion of vestibuloactive drug or drugs. It is a less destructive treatment approach, not a labyrinthectomy.
What documentation supports reporting this code?
Document the vertigo indication, affected side, transcanal approach, and the labyrinthine structures treated. The operative note should distinguish the procedure from one performed with mastoidectomy.
How should bilateral labyrinthectomy be reported?
CMS identifies this as a bilateral procedure reported with modifier 50, paid at 150%. The record should support surgery on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery. 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.
7,66269745,,Repair facial nerve,A,,16.59,13.55,NA,13.55,,2.42,32.56,32.56,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,66369799,,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