Summary & Overview
CPT 69554: Excision of Aural Glomus Tumor with Mastoidectomy
CPT code 69554 represents surgical excision of an aural glomus tumor approached from in front of the ear, typically involving a mastoidectomy and, when required for complete removal, extension to craniotomy and resection of adjacent structures. This code captures a complex otologic/neurosurgical procedure used primarily to relieve pain and remove locally invasive vascular tumors. Nationally, 69554 is relevant for tertiary surgical centers and hospital coding and reimbursement workflows because it denotes a high-complexity operative service with potential multi-specialty involvement. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn clinical context for the procedure, expected sites of service, and what operational stakeholders should consider when coding and classifying claims for glomus tumor excision. The publication outlines benchmark elements and policy-relevant considerations such as the procedure’s complexity, common billing modifiers, and typical facility setting, and it highlights areas where coding clarity affects hospital billing, prior authorization, and claim adjudication. Data not available in the input are noted where applicable; the focus remains on nationally relevant coding and clinical description rather than state-specific rules.
Billing Code Overview
CPT code 69554 describes surgical removal of an aural glomus tumor via a preauricular (in front of the ear) approach. The procedure typically includes a mastoidectomy and, when necessary to achieve complete tumor excision, may extend to a craniotomy and removal of nearby structures such as the parotid gland, external ear canal, and/or ossicles. The stated clinical intent in the description is pain relief.
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Service type: Major operative procedure (tumor excision with possible cranial extension)
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Typical site of service: Hospital operating room or tertiary surgical center where mastoidectomy and cranial procedures are performed
Data not available in the input for payers, associated taxonomies, or ICD-10 diagnoses.
Clinical & Coding Specifications
Clinical Context
A 56-year-old male presents with progressive pulsatile tinnitus, conductive hearing loss on the right, and intermittent otalgia. Imaging (contrast-enhanced MRI and CT temporal bones) demonstrates a vascular mass centered in the middle ear and mastoid consistent with an aural glomus (glomus jugulare/glomus tympanicum) tumor causing bone erosion and significant pain. The surgeon elects to perform a transmastoid/middle cranial fossa approach from in front of the ear to achieve complete tumor removal.
Preoperative workflow includes consultation with otolaryngology-head and neck surgery and neurotology, preoperative angiography with possible embolization by interventional radiology, baseline audiometry, and anesthesia assessment. Intraoperatively, the team performs a mastoidectomy with exposure of the tumor, possible removal of ossicles, canalplasty, and, if required by tumor extent, a limited craniotomy and parotid mobilization to achieve clear margins. The procedure is coded as 69554. Postoperative care includes observation for cranial nerve deficits, pain control, wound care, audiology follow-up, and surveillance imaging.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the operation requires substantially greater effort, time, or complexity than typical for . |