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CPT 69604: Revision Mastoidectomy with Tympanoplasty
CPT code 69604 covers revision mastoidectomy performed with tympanoplasty to repair a failed prior mastoidectomy and reconstruct the tympanic membrane. This code identifies a focused otologic surgical intervention used when persistent middle ear infection, eardrum perforation, and ongoing hearing loss follow an earlier surgery. Nationally, the code matters because it captures care for recurrent or chronic ear disease that may require repeat operative management and has implications for surgical outcomes, utilization monitoring, and payment policy for complex ear procedures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical indications tied to the code, common sites of service, and the typical clinical context driving use of the code. Readers will find benchmarks for service classification, a summary of payer coverage considerations (where available), and guidance on how the procedure is categorized for billing and reporting purposes. The content also highlights procedural intent — achieving a dry ear and restoring tympanic membrane integrity — and situates the code within broader surgical management of recurrent otitis media and chronic suppurative middle ear disease.
Data not available in the input for specific payer policies, reimbursement rates, associated taxonomies, and ICD-10 diagnosis mappings.
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Billing Code Overview
CPT code 69604 describes a revision of a previously performed mastoidectomy in conjunction with tympanoplasty, or reconstruction of the eardrum. The procedure is performed when an initial mastoidectomy and tympanoplasty failed to produce a dry ear, resulting in recurrent otitis media with purulent drainage, persistent eardrum perforation, and recurrent or residual hearing loss.
Service type: Revision mastoidectomy with tympanoplasty (ear reconstruction)
Typical site of service: Hospital outpatient surgical department or ambulatory surgical center, where otologic surgical procedures and middle ear reconstructions are routinely performed.