No office rate
69501 represents a simple mastoidectomy. Use 69505 when the operative work and documented extent support a radical mastoidectomy.
On this page
CMS RVU26D · Effective 2026-10-01
69505 Mastoidectomy Medicare reimbursement rates in Rhode Island
Reports radical mastoid surgery to remove extensive disease involving the mastoid and create an open cavity, commonly for advanced chronic ear disease. Compare 69505 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 69505 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
$1150.70
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 69505: Radical mastoidectomy
Reports radical mastoid surgery to remove extensive disease involving the mastoid and create an open cavity, commonly for advanced chronic ear disease.
An otolaryngologist performs a radical mastoidectomy in the operating room to remove diseased mastoid and middle-ear structures and create an open cavity. It is generally used for extensive chronic ear disease, including cholesteatoma, when a less extensive mastoid operation is not sufficient. The operative report should describe the disease and the extent of removal so the radical procedure can be distinguished from a simple or complete mastoidectomy.
Report 69505 for the radical mastoidectomy itself; a radical mastoidectomy performed with tympanoplasty is represented by a different code. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with 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 69505
- 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 RVU12.84 · 38%
- Practice expense (office) RVU19.07 · 56%
- Malpractice RVU1.87 · 6%
45
Medicare services in 2024 · #5426 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.
69505 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
69502 represents a complete mastoidectomy, while 69505 is for radical mastoid surgery. Base selection on the procedure actually documented, not the diagnosis alone.
No office rate
69511 is the combined radical mastoidectomy and tympanoplasty code. Use 69505 for the radical mastoidectomy without that combined tympanoplasty service.
Compare 69505 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
$1150.70
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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 69505 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
7,611
- Code
- 69505
- Physician work
- 12.84
- Practice expense
- 19.07
- Malpractice
- 1.87
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.84 | × 1.019 | 13.0840 |
| Practice expense | 19.07 | × 1.033 | 19.6993 |
| Malpractice | 1.87 | × 0.892 | 1.6680 |
| Total RVUs | 34.4513 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$1150.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.84 | 1.019 |
| Practice expense | 19.07 | 1.033 |
| Malpractice | 1.87 | 0.892 |
(12.84 × 1.019 + 19.07 × 1.033 + 1.87 × 0.892) × $33.4009 = $1150.70
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.
69505 billing questions
How does 69505 differ from a complete mastoidectomy?
Use 69505 when the operative work is a radical mastoidectomy, not simply a complete removal of mastoid air cells. The operative report should support the greater extent and radical nature of the procedure.
Can 69505 be reported with tympanoplasty?
A radical mastoidectomy performed with tympanoplasty is represented by 69511. Do not report 69505 as though it were the combined procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral 69505 reported?
For a bilateral procedure, report modifier 50; Medicare pays the bilateral procedure at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% 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.
7,60869450,,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
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
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