No office rate
69502 reports complete mastoidectomy. Choose 69700 for closure of the mastoid fistula; report both only when both procedures are performed and documented.
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CMS RVU26D · Effective 2026-10-01
69700 Fistula closure Medicare reimbursement rates in Texas
Reports operative closure of a persistent tract connecting the mastoid region with the skin, commonly after mastoid surgery or chronic ear disease. Compare 69700 office and facility rates across CMS payment localities in Texas.
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 69700 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 69700 pays more and less in Texas
Otologic surgery
About 69700: Surgical closure of mastoid fistula
Reports operative closure of a persistent tract connecting the mastoid region with the skin, commonly after mastoid surgery or chronic ear disease.
An otologist or other ear surgeon closes a persistent opening between the mastoid cavity or bone and the skin. This may be needed for a draining opening that remains after mastoid surgery or develops with chronic ear disease. The surgeon exposes the tract and closes it using the operative approach and tissue repair appropriate to the documented defect. The service is generally performed in an operating room rather than as routine office wound care.
Report 69700 when the operative work is specifically closure of a mastoid fistula; document the site, laterality, cause when known, and repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 69700
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.16 · 46%
- Practice expense (office) RVU8.54 · 48%
- Malpractice RVU1.21 · 7%
17
Medicare services in 2024 · #6022 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.
69700 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
69511 describes modified radical mastoidectomy, rather than closure of a mastoid fistula. The operative work determines whether this code, 69700, or both apply.
69799
No office rateUnlisted px middle ear
69799 is the unlisted middle-ear procedure code. Use 69700 when the service is specifically closure of a mastoid fistula; 69799 is for a distinct procedure without a more specific code.
Compare 69700 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $610.69 |
| Beaumont | Office Unavailable | Facility $569.67 |
| Brazoria | Office Unavailable | Facility $588.93 |
| Dallas | Office Unavailable | Facility $593.78 |
| Fort Worth | Office Unavailable | Facility $591.46 |
| Galveston | Office Unavailable | Facility $591.44 |
| Houston | Office Unavailable | Facility $613.59 |
| Rest Of Texas | Office Unavailable | Facility $579.74 |
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69700 billing questions
When is 69700 the appropriate code?
Use it for operative closure of a fistulous tract involving the mastoid region. A mastoidectomy or repair of another ear structure is not a substitute when that separate service is performed.
Can a mastoidectomy be reported in the same session?
A separately performed mastoidectomy may be reported when the operative note supports distinct mastoid work in addition to fistula closure. Document both services and the work performed for each.
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.
How should bilateral closure be reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be billed?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
7,64269667,,Repair middle ear structures,A,,9.65,10.58,NA,10.58,,1.44,21.67,21.67,0,090,0.07,0.79,0.14,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,64369670,,Remove mastoid air cells,A,,11.44,12.04,NA,12.04,,1.67,25.15,25.15,0,090,0.07,0.79,0.14,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,64469676,,Remove middle ear nerve,A,,9.45,11.55,NA,11.55,,1.36,22.36,22.36,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,64569700,,Close mastoid fistula,A,,8.16,8.54,NA,8.54,,1.21,17.91,17.91,0,090,0.07,0.79,0.14,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,64669705,,Nps surg dilat eust tube uni,A,,2.93,73.58,,1.08,,0.43,76.94,4.44,0,000,0.00,0.00,0.00,3,0,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
7,64769706,,Nps surg dilat eust tube bi,A,,4.16,74.90,,1.39,,0.60,79.66,6.15,0,000,0.00,0.00,0.00,3,2,0,0,0,9,31231,33.4009,09,0,99,0.00,0.00,0.00
7,64869710,,Implant/replace hearing aid,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00