No office rate
69970 describes removal of a focal lesion. 69905 applies when the surgeon performs a labyrinthectomy rather than excising a lesion.
On this page
CMS RVU26D · Effective 2026-10-01
69970 Inner ear surgery Medicare reimbursement rates in Wisconsin
Surgical removal of a focal lesion involving the inner-ear region, reported when the operative service is lesion excision rather than treatment of inner-ear function. Compare 69970 office and facility rates across CMS payment localities in Wisconsin.
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 69970 in Wisconsin?
Wisconsin 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
$1709.26
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 69970: Inner ear lesion excision
Surgical removal of a focal lesion involving the inner-ear region, reported when the operative service is lesion excision rather than treatment of inner-ear function.
This service involves surgically removing a focal lesion involving the inner-ear region, often through an operation that requires exposure of the temporal bone or mastoid. It is typically performed by an otologist or neurotologist in a hospital operating room; complex skull-base cases may involve a neurosurgeon as well. The operative target is a lesion, not simply removal or destruction of inner-ear structures to treat a functional disorder.
Report the code when the operative report supports excision of an inner-ear lesion and describes its site, extent, and surgical work. A description of the approach and any mastoid or temporal-bone work helps distinguish lesion excision from a labyrinthectomy or nerve procedure. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 69970
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU31.60 · 57%
- Practice expense (office) RVU18.95 · 34%
- Malpractice RVU4.61 · 8%
28
Medicare services in 2024 · #5721 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.
69970 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
Choose 69910 for inner-ear removal that includes mastoid work; choose 69970 when the documented service is focal lesion excision.
69949
No office rateUnlisted px inner ear
69949 is the unlisted option for an inner-ear procedure without a specific listed code. Use 69970 when its defined lesion-removal service matches the operation.
69979
No office rateUnlisted px temporal bone
69979 covers an unlisted temporal-bone procedure. It is not the specific lesion-removal code when the operative service is described by 69970.
Compare 69970 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$1709.26
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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 69970 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
7,675
- Code
- 69970
- Physician work
- 31.60
- Practice expense
- 18.95
- Malpractice
- 4.61
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.60 | × 1.000 | 31.6000 |
| Practice expense | 18.95 | × 0.958 | 18.1541 |
| Malpractice | 4.61 | × 0.308 | 1.4199 |
| Total RVUs | 51.1740 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$1709.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 31.6 | 1 |
| Practice expense | 18.95 | 0.958 |
| Malpractice | 4.61 | 0.308 |
(31.6 × 1 + 18.95 × 0.958 + 4.61 × 0.308) × $33.4009 = $1709.26
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.
69970 billing questions
How is this distinguished from a labyrinthectomy?
This code is for removal of a focal lesion. A labyrinthectomy removes inner-ear structures; select the code that matches the operation actually performed and documented.
What operative documentation supports the code?
Document the lesion's location and extent, the structures involved, the approach, and the excision performed. Include related mastoid or temporal-bone work when present.
Can modifier 50 be reported for bilateral surgery?
Yes. CMS treats the procedure as bilateral with modifier 50 and pays it at 150%.
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 may be allowed. Co-surgeon payment requires supporting documentation; team surgery is 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 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.
7,67269950,,Incise inner ear nerve,A,,26.94,14.37,NA,14.37,,3.93,45.24,45.24,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,67369955,,Release facial nerve,A,,28.68,18.26,NA,18.26,,4.18,51.12,51.12,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,67469960,,Release inner ear canal,A,,28.68,16.02,NA,16.02,,4.18,48.88,48.88,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,67569970,,Remove inner ear lesion,A,,31.60,18.95,NA,18.95,,4.61,55.16,55.16,0,090,0.07,0.79,0.14,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,67669979,,Unlisted px temporal bone,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,67769990,,Microsurgery add-on,R,,3.37,1.17,NA,1.17,,1.39,5.93,5.93,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,67870010,,Contrast x-ray of brain,A,,1.16,0.21,NA,0.21,,0.11,1.48,1.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,