CPT code 69700: Fistula closure2026 Medicare rate & RVUs in Virginia
Reports operative closure of a persistent tract connecting the mastoid region with the skin, commonly after mastoid surgery or chronic ear disease.
CMS doesn’t publish an office rate for 69700 in Virginia.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 69700 covers
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.
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.
Where 69700 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $668.27 |
| Virginia | Unavailable | $581.48 |
How the 69700 rate is calculated
Each of 69700’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 69700
RVUs × geographic indexes × conversion factor
Work8.16
8.16 RVUs× 1.000 GPCI
Practice expense8.54
8.54 RVUs× 1.000 GPCI
Malpractice1.21
1.21 RVUs× 1.000 GPCI
Adjusted RVUs
17.9100
Conversion factor
$33.4009
Medicare rate
$598.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69700
69700 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69700
Fistula closure
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.07/0.79/0.14 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 69700
Fistula closure
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
69700 without 50 · national facility
$598.21
Fistula closure
69700-50 · Bilateral: 150%
$897.32
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
69700 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69502Mastoidectomy
- 69502 reports complete mastoidectomy. Choose 69700 for closure of the mastoid fistula; report both only when both procedures are performed and documented.
- 69511Mastoid surgery
- 69511 describes modified radical mastoidectomy, rather than closure of a mastoid fistula. The operative work determines whether this code, 69700, or both apply.
- 69799Unlisted 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.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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