CPT 69662 Revision Stapedectomy Reimbursement | OpenPayer

Summary & Overview

CPT 69662: Revision of Stapedectomy/Stapedotomy for Fixated Stapes

CPT code 69662 covers revision surgery for a previously performed stapedectomy or stapedotomy to correct a fixated stapes bone and restore ossicular continuity and hearing function. This otologic reconstructive procedure matters nationally because it addresses persistent or recurrent conductive hearing loss, impacts surgical quality measures in otology, and can influence provider reimbursement and utilization patterns for middle ear surgery.

Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The code is relevant across hospital operating rooms and ambulatory surgery centers where otologic surgeons perform middle ear revision procedures.

Readers will find a concise overview of clinical intent and service setting, coverage and billing considerations across major national payers, commonly reported modifiers and administrative notes, and context for coding choices in revision stapedial surgery. The publication summarizes typical sites of service, common billing modifiers associated with surgical revisions, and practical procedural descriptions to support accurate claim submission. Data not available in the input are explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare69662CPTstapedectomystapedotomyotologymiddle-ear-surgeryrevision-surgeryambulatory-surgery-centerhospital-operating-room

Billing Code Overview

CPT code 69662 describes a surgical procedure to revise a previously performed stapedectomy or stapedotomy to correct a fixated stapes bone. The revision can include separation of the stapes and incus, drilling of the footplate, manipulation or replacement of the stapes prosthesis, and other measures that reestablish ossicular continuity, increase stapes mobility, and improve hearing.

Service type: Middle ear reconstructive surgery / otologic revision procedure

Typical site of service: Hospital operating room or ambulatory surgery center (ASC)

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with a history of prior stapedectomy presents with progressive conductive hearing loss and intermittent aural fullness on the operated side. Audiometry demonstrates a widened air-bone gap consistent with stapes fixation or prosthesis malfunction. Imaging and clinical exam suggest a fixed stapes prosthesis with reduced ossicular mobility. The otologic surgeon schedules a revision stapedectomy/stapedotomy to correct the fixated stapes bone, which may involve separation of the stapes and incus, drilling of the footplate, manipulation or replacement of the stapes prosthesis, and reestablishment of ossicular continuity.

Preoperative workflow includes focused history and ear exam, diagnostic audiometry and tympanometry, informed consent discussing risks (hearing change, vertigo, taste disturbance, tympanic membrane injury), and relevant pre-op clearance. The procedure is typically performed in an ambulatory surgery center or hospital operating room under monitored anesthesia care or general anesthesia. Intraoperative steps include canal or endaural exposure, identification and mobilization of the ossicular chain, removal or adjustment of the previous prosthesis, controlled footplate work (drilling or laser as indicated), placement of a new prosthesis as needed, and intraoperative assessment of ossicular mobility. Postoperative workflow includes bedside recovery, audiology follow-up, and a short-term activity and medication plan documented in the chart.

Coding Specifications

Modifier	Description	When to Use
`00`

CPT 69604: Revision Mastoidectomy with Tympanoplasty

CPT-69642-TYMPANOPLASTY-MASTOIDECTOMY-OSSICULAR-RECONSTRUCTION

CPT 69642: Tympanic Membrane Repair with Mastoidectomy and Ossicular Reconstruction

CPT-69670-MASTOID-OBLITERATION-FOR-CSF-LEAK-PREVENTION

CPT 69670: Mastoid Obliteration to Prevent or Stop CSF Leak

CPT-69603-REVISION-RADICAL-MASTOIDECTOMY

CPT 69603: Revision Radical Mastoidectomy, Ossicle and Middle Ear Excision

CPT-69645-RADICAL-TYMPANIC-MEMBRANE-RECONSTRUCTION-MASTOIDECTOMY

CPT 69645: Radical Tympanic Membrane Reconstruction with Mastoidectomy

CPT-69636-TYMPANIC-MEMBRANE-OSSICULAR-RECONSTRUCTION-MASTOIDECTOMY

CPT 69636: Tympanic Membrane Repair with Ossicular Reconstruction and Mastoidectomy

CPT-69602-MODIFIED-RADICAL-MASTOIDECTOMY-REVISION

CPT 69602: Revision to Modified Radical Mastoidectomy

CPT-69646-RADICAL-TYMPANOPLASTY-MASTOIDECTOMY-OSSICULAR-RECONSTRUCTION

CPT 69646: Radical Tympanoplasty with Mastoidectomy and Ossicular Reconstruction

CPT-69633-TYMPANIC-MEMBRANE-AND-OSSICULAR-RECONSTRUCTION-WITH-PROSTHESIS

CPT 69633: Tympanic Membrane and Ossicular Reconstruction with Prosthesis

CPT-69635-TYMPANOPLASTY-WITH-MASTOIDECTOMY-INITIAL-OR-REVISION

CPT 69635: Tympanic Membrane Reconstruction with Mastoidectomy

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Taxonomy Code	Specialty	Notes
207Y00000X	Otolaryngology (ENT)	Primary specialty performing stapedectomy revision and ossicular surgery.
208800000X	Otology/Neurotology	Subspecialists who frequently perform complex ossicular and revision middle ear procedures.
163W00000X	Anesthesiology	Provides general or monitored anesthesia care for the procedure.
253E00000X	Audiology	Performs pre- and postoperative audiometric testing and intraoperative monitoring support in some centers.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H80.09`	Otosclerosis, unspecified ear	Otosclerosis is a primary cause of stapes fixation leading to conductive hearing loss and is a common indication for stapedectomy revision.
`H81.3`	Other peripheral vertigo	Vertigo can be a presenting or postoperative symptom associated with stapes fixation or prosthesis malfunction and may affect perioperative management.
`H90.3`	Sensorineural hearing loss, bilateral	While stapedectomy targets conductive loss, mixed or sensorineural components are relevant for surgical planning and prognosis.
`H90.2`	Conductive hearing loss, bilateral	Directly related to ossicular fixation and a primary clinical indication for stapes surgery or revision.
`H72.9`	Unspecified suppurative and nonsuppurative otitis media	Chronic middle ear disease may complicate ossicular surgery and influence revision approach.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`69620`	Myringotomy with insertion of ventilating tube (tympanostomy tube)	Performed for middle ear ventilation issues; may precede or accompany middle ear surgery in patients with chronic eustachian dysfunction.
`69990`	Microscopic or endoscopic surgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure)	Billed in some settings when an operating microscope is an identifiable additional service during ear surgery depending on payer policy.
`69932`	Middle ear exploration with tympanoplasty, ossicular reconstruction, any method (includes ossicular chain reconstruction)	Related ossiculoplasty or tympanoplasty procedures that may be performed during the same operative session if additional reconstruction beyond stapes prosthesis replacement is required.
`92587`	Auditory evoked potentials for evoked response; limited recording	Intraoperative or perioperative auditory testing may be used adjunctively to assess cochlear/nerve function during revision stapes surgery.
`99100`	Anesthesia for patient of extreme age, younger than 1 year/older than 70 years, in special circumstances (add-on)	Used as an example of anesthesia add-on codes that may be applicable for high-risk patients when billing anesthesia services alongside the procedure.

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