No office rate
69501 represents a more limited mastoid operation. Report 69502 when the operative documentation supports the complete mastoid dissection rather than the limited service.
On this page
CMS RVU26D · Effective 2026-10-01
69502 Mastoidectomy Medicare reimbursement rates in Rhode Island
Reports complete surgical removal of diseased mastoid air cells, typically for chronic ear disease, when the operative extent supports this level of mastoid surgery. Compare 69502 office and facility rates across CMS payment localities in Rhode Island.
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 69502 in Rhode Island?
Rhode Island 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
$853.89
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 69502: Complete mastoid air-cell surgery
Reports complete surgical removal of diseased mastoid air cells, typically for chronic ear disease, when the operative extent supports this level of mastoid surgery.
An otolaryngologist performs this operation to open the mastoid behind the ear and remove diseased air cells. Typical indications include chronic mastoid infection or cholesteatoma involving the mastoid. The operative report should make clear the extent of the dissection and distinguish it from a more limited mastoid operation or a more extensive procedure. This service is generally performed in a hospital or other surgical facility.
Select the code from the documented operative work, not the diagnosis alone. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 69502
- 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 RVU12.25 · 49%
- Practice expense (office) RVU11.11 · 44%
- Malpractice RVU1.80 · 7%
338
Medicare services in 2024 · #3895 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.
69502 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
69505 represents a modified radical mastoid operation. The surgeon’s documented operative technique and extent distinguish it from 69502.
No office rate
69511 is for a radical mastoid operation, a different and broader operative service. Do not select it solely because the case involves severe disease.
Compare 69502 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$853.89
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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 69502 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,610
- Code
- 69502
- Physician work
- 12.25
- Practice expense
- 11.11
- Malpractice
- 1.80
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.25 | × 1.019 | 12.4827 |
| Practice expense | 11.11 | × 1.033 | 11.4766 |
| Malpractice | 1.80 | × 0.892 | 1.6056 |
| Total RVUs | 25.5650 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$853.89
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.25 | 1.019 |
| Practice expense | 11.11 | 1.033 |
| Malpractice | 1.8 | 0.892 |
(12.25 × 1.019 + 11.11 × 1.033 + 1.8 × 0.892) × $33.4009 = $853.89
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.
69502 billing questions
How is this different from 69501?
The distinction is the extent of the mastoid operation. Use the operative report to determine whether the work is the complete dissection represented by 69502 or the more limited operation represented by 69501.
When should 69505 be considered instead?
69505 represents a modified radical mastoid operation. Choose between it and 69502 based on the operative extent and technique documented, rather than the diagnosis by itself.
How should bilateral surgery be reported?
Report bilateral surgery with modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant-at-surgery claim be submitted?
Yes, when the record documents medical necessity for the assistant. CMS does not permit co-surgeon or team-surgery reporting for this code.
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.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are paid at 50% under the standard multiple procedure reduction.
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.
7,60769440,,Exploration of middle ear,A,,7.52,10.06,NA,10.06,,1.11,18.69,18.69,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60869450,,Eardrum revision,A,,5.55,8.52,NA,8.52,,0.81,14.88,14.88,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,60969501,,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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537