69806 Labyrinthectomy Medicare reimbursement rates in Pennsylvania

An otologist or other ear surgeon uses a mastoid approach to reach and ablate the labyrinth, the inner-ear structure responsible for balance. The operation intentionally eliminates vestibular function on the treated side and may be considered for intractable vertigo, including selected patients with Ménière disease and nonserviceable hearing. It is performed in an operating room; the documented approach distinguishes it from a transcanal labyrinthectomy.

Report this code when the operative record supports labyrinthectomy performed through a mastoid approach, rather than medication perfusion or a transcanal operation. Documentation should identify the indication, treated side, surgical approach, and work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.