CPT 0955T: Removal of Totally Implantable Active Middle Ear Implant - OpenPayer

Summary & Overview

CPT 0955T: Removal of Totally Implantable Active Middle Ear Implant

CPT code 0955T denotes the surgical removal of all components of a totally implantable active middle ear hearing implant (AMEI). This explantation code captures a specialized otologic procedure that has implications for device management, post-implant care, and surgical billing. Nationally, accurate coding of device explantation affects claims processing, quality measurement, and longitudinal device registries.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for AMEI explantation, typical sites of service, and common billing considerations tied to the code definition. The publication summarizes benchmarks and payment patterns where available, highlights relevant policy updates affecting device explantation billing, and situates the code within otologic surgical service lines.

The report is intended to help coding professionals, revenue cycle managers, and clinical leaders understand how CPT code 0955T is used, what procedural scenarios it represents, and which payers are most relevant for coverage and claims adjudication. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare0955TCPTmiddle ear implantAMEIexplantationotologysurgical procedureambulatory surgerydevice removal

Billing Code Overview

CPT code 0955T describes the removal of all components of a totally implantable active middle ear hearing implant (AMEI). This procedure entails explantation of a fully implanted active middle ear device and all of its implanted components.

Service type: Surgical explantation of an active middle ear implant
Typical site of service: Hospital operating room or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with a previously implanted totally implantable active middle ear hearing implant (AMEI) presents with device failure and persistent pain at the implant site. The patient reports decreased amplification and intermittent non-auditory sensations. Imaging and device interrogation confirm nonfunctional internal components with no feasible reprogramming or in-office corrective measures. After consultation, the otologist schedules operative removal of all components of the totally implantable AMEI under general anesthesia. The typical clinical workflow includes preoperative evaluation (history, physical exam, audiometry, device check, and imaging as indicated), informed consent documenting risks of explantation and possible hearing outcome changes, perioperative antibiotic prophylaxis as indicated, operative removal of the internal receiver-stimulator, fixation hardware, and any electrode or coupling elements, intraoperative hemostasis and wound closure, immediate postoperative recovery with pain control and wound care instructions, and scheduled follow-up for wound assessment and audiologic rehabilitation planning.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for the explantation due to extensive scarring, complex dissection, or prolonged operative time and documentation supports unusual effort.

CPT 0952T: Revision or Replacement of Implantable Active Middle Ear Hearing Device

cpt-0951t-active-middle-ear-implant-surgery

CPT 0951T: Implantation of Active Middle Ear Hearing Implant

cpt-0953t-amei-revision-or-replacement

CPT 0953T: Revision or Replacement of Active Middle Ear Implant

cpt-0954t-amei-sound-processor-replacement

CPT 0954T: AMEI Sound Processor Replacement and Reattachment

Taxonomy Code	Specialty	Notes
206E00000X	Otolaryngology (ENT)	Primary specialty performing implant removal and middle ear surgery.
207RH0000X	Otology/Neurotology	Subspecialists who manage middle ear implants and complex explantation.
2084P0800X	General Surgery — Head & Neck Surgery (if applicable)	Occasionally involved when concurrent head and neck procedures occur.
367H00000X	Audiology	Provides pre- and postoperative audiometric assessment and device testing; not a surgical taxonomy but integral to workflow.
3336S0110X	Implantable Device Specialist / Biomedical Engineering (clinical)	Involved for device interrogation, explant device handling, and coordination with manufacturer.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H93.23`	Central auditory processing disorder	May be present in patients with complex auditory complaints leading to implant revision or removal when implant fails to provide expected benefit.
`H91.90`	Unspecified hearing loss, unspecified ear	Common presenting diagnosis when an implanted AMEI ceases to provide adequate hearing improvement and explantation is considered.
`T85.898A`	Other mechanical complication of other specified implanted devices, initial encounter	Used when the implant has mechanical failure necessitating removal.
`T86.890A`	Other complications of transplanted organ and tissue, initial encounter	Occasionally used for significant device-related complications requiring operative management; selection depends on payer guidance.
`H60.93`	Otitis externa, unspecified ear	Peri-auricular or canal infections that complicate implanted device function and may prompt explantation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`69590`	Myringotomy with aspiration and/or with insertion of ventilation tube (requiring general anesthesia in some cases)	Performed preoperatively or concurrently for middle ear access or management of middle ear pathology during implant explantation when indicated.
`69930`	Removal of neurostimulator electrode array from brain or spinal cord, intracranial	Not directly related anatomically but included to illustrate removal of implanted neurodevices; contrast procedural coding considerations for explanting implanted devices.
`64585`	Revision or removal of peripheral nerve stimulator electrode, open; without replacement	Analogous in coding principles for removal of implanted auditory stimulators when components are extracted without replacement.
`69720`	Mastoidectomy, any type; modified radical (if performed)	May be necessary if mastoid exposure or extensive dissection is required during explantation for device access or infection control.
`69990`	Unlisted procedure, nervous system	Use when a specific component removal or unusual device explantation is not represented by an existing CPT code and documentation supports use of an unlisted code; payer-specific preauthorization may be required.
`99100`	Anesthesia for patient of extreme age, younger than 1 year or older than 70 years, when performed by the anesthesiologist	May apply to perioperative care reporting when advanced age contributes to increased anesthesia complexity; billing rules vary by payer.

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