Billing code 69602: Mastoid revisionMedicare rate & RVUs in Washington
Reports revision of a previously operated mastoid, with the resulting surgical cavity reaching a modified radical configuration, commonly for persistent or recurrent ear disease.
CMS doesn’t publish an office rate for 69602 in Washington.
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 69602 covers
An otolaryngologist revises a mastoid that has undergone prior surgery and extends the work to a modified radical configuration. This may be needed for persistent or recurrent disease, including cholesteatoma. The procedure is generally performed in an operating room; the operative findings and the completed surgical result distinguish it from a less extensive revision or a revision ending in a different mastoid configuration.
Report this code when the documented result is modified radical extent, not simply because the patient has had prior mastoid surgery. The operative report should identify the prior surgical site, the disease or findings addressed, and the extent and result of the revision. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 69602 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $980.46 |
| Seattle (King Cnty) | Unavailable | $1,079.46 |
How the 69602 rate is calculated
Each of 69602’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 · 69602
RVUs × geographic indexes × conversion factor
Work13.42
13.42 RVUs× 1.000 GPCI
Practice expense13.55
13.55 RVUs× 1.000 GPCI
Malpractice1.96
1.96 RVUs× 1.000 GPCI
Adjusted RVUs
28.9300
Conversion factor
$33.4009
Medicare rate
$966.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 69602
69602 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 69602
Mastoid revision
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 69602
Mastoid revision
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
69602 without 50 · national facility
$966.29
Mastoid revision
69602-50 · Bilateral: 150%
$1,449.44
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).
69602 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 69601Mastoid revision
- Use 69601 when the documented revision results in a complete mastoidectomy configuration; use 69602 for a modified radical result.
- 69603Mastoid revision
- Use 69603 when the revision results in a radical mastoidectomy configuration. The distinguishing endpoint for 69602 is modified radical extent.
- 69604Mastoid revision
- Use 69604 when the revision results in tympanoplasty. Select 69602 when the documented surgical result is a modified radical mastoid configuration.
69602 billing questions
How is this code distinguished from 69601 or 69603?
Choose based on the documented result of the revision: this code indicates a modified radical configuration, while 69601 and 69603 represent complete and radical outcomes, respectively.
When is 69604 a better fit?
Use 69604 when the revision results in tympanoplasty. This code is for a revision whose documented result is a modified radical mastoid configuration.
What documentation supports reporting this code?
The operative report should establish prior mastoid surgery, describe the findings and work performed, and document that the revision resulted in modified radical extent.
Can both ears be reported?
For a bilateral procedure, CMS pays this code with modifier 50 at 150%. The operative documentation should support the procedure on both sides.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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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