No office rate
69505 describes a modified radical mastoidectomy. Report 69511 when the operative work supports the more extensive radical procedure.
On this page
CMS RVU26D · Effective 2026-10-01
69511 Mastoid surgery Medicare reimbursement rates in Oklahoma
Reports radical mastoid surgery to eradicate extensive mastoid and middle-ear disease, such as cholesteatoma, when tympanoplasty is not part of the procedure. Compare 69511 office and facility rates across CMS payment localities in Oklahoma.
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 69511 in Oklahoma?
Oklahoma 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
$1069.52
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 69511: Radical mastoidectomy
Reports radical mastoid surgery to eradicate extensive mastoid and middle-ear disease, such as cholesteatoma, when tympanoplasty is not part of the procedure.
An otolaryngologist performs a radical mastoidectomy in the operating room to remove extensive disease involving the mastoid and middle ear and create an open surgical cavity. It is used for advanced chronic ear disease, including cholesteatoma, when the operative work is more extensive than a simple, complete, or modified radical mastoidectomy. Code 69511 distinguishes this operation from radical mastoidectomy performed with tympanoplasty.
Choose the code from the operative report’s documented extent and whether tympanoplasty was performed; the diagnosis alone does not establish the surgical level. Medicare 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 the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 69511
- 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 RVU13.36 · 39%
- Practice expense (office) RVU19.20 · 56%
- Malpractice RVU1.95 · 6%
29
Medicare services in 2024 · #5696 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.
69511 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
69502 is for complete mastoidectomy; 69511 is for radical mastoid surgery involving a more extensive operation.
No office rate
Both describe radical mastoid surgery, but 69530 is the code to consider when tympanoplasty is performed with it.
Compare 69511 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$1069.52
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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 69511 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
7,612
- Code
- 69511
- Physician work
- 13.36
- Practice expense
- 19.20
- Malpractice
- 1.95
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.36 | × 1.000 | 13.3600 |
| Practice expense | 19.20 | × 0.893 | 17.1456 |
| Malpractice | 1.95 | × 0.777 | 1.5151 |
| Total RVUs | 32.0207 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$1069.52
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.36 | 1 |
| Practice expense | 19.2 | 0.893 |
| Malpractice | 1.95 | 0.777 |
(13.36 × 1 + 19.2 × 0.893 + 1.95 × 0.777) × $33.4009 = $1069.52
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.
69511 billing questions
How is 69511 distinguished from a modified radical mastoidectomy?
69511 represents radical mastoid surgery, a more extensive operation than the modified radical mastoidectomy reported with 69505. Use the operative report to identify the actual extent performed.
When should 69530 be considered instead?
Use 69530 when the radical mastoidectomy is performed with tympanoplasty. Code 69511 describes radical mastoid surgery without that tympanoplasty distinction.
What documentation supports 69511?
The operative report should describe the disease treated, the extent of mastoid and middle-ear removal, and the creation of the surgical cavity. It should also make clear whether tympanoplasty was performed.
How is bilateral 69511 paid?
CMS pays bilateral surgery reported with modifier 50 at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
7,60969501,,Mastoidectomy,A,,8.98,8.74,NA,8.74,,1.31,19.03,19.03,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61069502,,Mastoidectomy,A,,12.25,11.11,NA,11.11,,1.80,25.16,25.16,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61169505,,Remove mastoid structures,A,,12.84,19.07,NA,19.07,,1.87,33.78,33.78,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61269511,,Extensive mastoid surgery,A,,13.36,19.20,NA,19.20,,1.95,34.51,34.51,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61369530,,Extensive mastoid surgery,A,,19.87,22.67,NA,22.67,,3.04,45.58,45.58,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61469535,,Remove part of temporal bone,A,,36.48,28.98,NA,28.98,,5.31,70.77,70.77,0,090,0.07,0.79,0.14,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,61569540,,Excision aural polyp,A,,1.22,4.89,,2.20,,0.18,6.29,3.60,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193