Summary & Overview

CPT 69300: Otoplasty/Auricular Reconstruction for Ear Deformity

CPT code 69300 identifies otoplasty and similar auricular reconstruction procedures that correct congenital or acquired ear deformities such as protruding ears. These procedures are commonly performed to improve cosmetic appearance and can have functional or psychosocial implications for patients. Nationally, coding and coverage for ear reconstruction matter for surgical access, cosmetic-versus-reconstructive determinations, and appropriate site-of-service billing.

Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of coverage considerations, billing practice benchmarks, and clinical context for use of CPT code 69300 across typical outpatient surgical settings.

Readers will learn the clinical intent of the code, typical sites where the service is delivered, common payer considerations, and where to find policy and billing guidance. Where available, benchmarking metrics and policy updates related to surgical ear reconstruction are summarized to aid coding accuracy and payer communication. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare69300CPTotoplastyauricular reconstructioncosmetic surgerysurgical billingoutpatient surgery

Billing Code Overview

CPT code 69300 describes a surgical procedure to rectify acquired or congenital deformities of the ear, for example a protruding ear. The provider reshapes structural ear elements to achieve a more desirable cosmetic appearance.

Service type: Surgical cosmetic/otologic reconstruction.
Typical site of service: Outpatient surgical center or hospital operating room, depending on case complexity and patient needs.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 12-year-old child presents to a pediatric otolaryngology clinic with bilateral prominent (protruding) ears causing social distress and bullying at school. Physical exam demonstrates well-formed auricular cartilage with an abnormal antihelical fold and conchal hypertrophy. After a preoperative consultation and informed consent, the patient is scheduled for elective outpatient otoplasty. The typical clinical workflow includes preoperative photography and marking, general anesthesia administered by an anesthesiologist, surgical reshaping of the auricular cartilage via incisions behind the ear to create or enhance the antihelical fold and reduce conchal prominence, placement of sutures or cartilage scoring as indicated, hemostasis, application of a head dressing, and same-day discharge with postoperative care instructions and a follow-up visit within 1–2 weeks for wound check and dressing removal. The site of service is an outpatient ambulatory surgery center or hospital outpatient department. The service type is a cosmetic/reconstructive otologic procedure focused on reshaping external ear structures to improve cosmetic appearance and correct acquired or congenital deformities.

Coding Specifications

Modifier	Description	When to Use
`00`	Reserved / Not used for Medicare billing	Data not typically used; present in input list

22 | Increased procedural services | When work required is substantially greater than usual (extensive scarring, revision otoplasty)

Taxonomy Code	Specialty	Notes
`2080S0106X`	Otolaryngology (ENT)	Primary specialty performing otoplasty and external auricular reconstruction

ICD-10 Code	Description	Clinical Relevance
`Q17.2`	Congenital malformation of ear, prominent ear	Classic congenital indication for otoplasty to correct prominent ear deformity

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`69300`	Otoplasty, modification of the external ear for protruding ear; without skin graft	Primary procedure code describing surgical reshaping of ear cartilage and soft tissue to correct protruding ear deformity

69320 | Otoplasty, reconstruction, large defects; with cartilage graft (e.g., major reconstruction) | Performed when otoplasty requires more extensive reconstruction or grafting for larger defects

12032 | Repair, intermediate, wounds of scalp, arms, legs, trunk; 2.6 cm to 7.5 cm | May be used for intermediate wound repair of postauricular incisions if separately reportable and not included in otoplasty global

99213 | Office or other outpatient visit for evaluation and management, established patient, low to moderate complexity | Preoperative consultation or routine postoperative follow-up visit in clinic

01991 | Anesthesia for operations on the ear, including tympanoplasty (Examples vary) | Anesthesia codes applicable to ear surgery; anesthesia services are reported separately by anesthesiologists or anesthesia providers

69210 | Removal of impacted cerumen requiring instrumentation (not directly related) | Not typically associated; included only when ear canal care is performed in same episode (If not applicable, omit in billing)

Note: When billing multiple codes, apply appropriate modifiers per payer rules. Payors commonly involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

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