Billing code 69728: Implant removalMedicare rate & RVUs in Virginia
Removal of a transcutaneous osseointegrated skull implant when the documented extent is 100 square centimeters or greater.
CMS doesn’t publish an office rate for 69728 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 69728 covers
This code describes operative removal of a transcutaneous osseointegrated implant in the skull, commonly part of a bone-conduction hearing system with an implant beneath the skin and an external sound processor. An otolaryngologist, often a neurotologist, typically performs the procedure in an operating room when the implant must be removed. The code’s extent category is 100 square centimeters or greater; the operative report should identify the transcutaneous approach and document the extent supporting that category.
Report this code for removal, not initial placement or replacement, and distinguish it from percutaneous implant removal. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures reported with modifier 50, payment is at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Medicare does not pay an assistant at surgery for this code; 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 69728 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $575.27 |
| Virginia | Unavailable | $504.40 |
How the 69728 rate is calculated
Each of 69728’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 · 69728
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.29Practice expense 6.06Malpractice 1.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 69728
69728 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69728
Implant removal
| 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 · 69728
Implant removal
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
69728 without 50 · national facility
$519.72
Implant removal
69728-50 · Bilateral: 150%
$779.58
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).
69728 compared with similar codes
Compare codes
69728 vs 69727 vs 69726 vs 69730: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 69727Implant removal
- Both codes describe transcutaneous implant removal; the distinction is the documented extent, below 100 square centimeters for 69727 versus 100 square centimeters or greater here.
- 69726Implant removal
- 69726 is for removal by a percutaneous approach. This code is for transcutaneous removal in the 100-square-centimeter-or-greater extent category.
- 69730Implant replacement
- 69730 describes replacement of a transcutaneous implant in the 100-square-centimeter-or-greater category. Choose this code when the procedure is removal rather than replacement.
69728 billing questions
How is this code distinguished from 69727?
Both describe removal of a transcutaneous osseointegrated skull implant. Use 69728 for documented extent of 100 square centimeters or greater and 69727 for extent below 100 square centimeters.
When should 69726 be considered instead?
69726 describes removal by a percutaneous approach. This code is for transcutaneous implant removal with the documented extent at or above the 100-square-centimeter threshold.
Is removal included when a new implant is placed?
This code represents removal, while placement or replacement has its own code. The operative report should make clear whether the service was removal alone or replacement of an existing implant.
What documentation supports reporting 69728?
Document the transcutaneous approach, that the procedure removed an osseointegrated skull implant, and the extent supporting the 100-square-centimeter-or-greater category.
How does Medicare handle bilateral reporting and multiple procedures?
A bilateral procedure reported with modifier 50 is paid at 150%. In a session with multiple procedures, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Medicare 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
Fee sheets
Put 69728 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →