CPT 69905 Labyrinthectomy Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 69905: Excision of the Labyrinth (Labyrinthectomy)

CPT code 69905 denotes the excision of the labyrinth (labyrinthectomy), a definitive surgical procedure that destroys the semicircular canals, utricle, and saccule to remove a diseased vestibular labyrinth. Nationally, this code is relevant for specialty otolaryngology and neurotology practices managing intractable vestibular disease, severe Meniere-like syndromes, or other pathologies where vestibular preservation is not feasible. The procedure is typically performed in hospital operating rooms or ambulatory surgical centers under general anesthesia.

Key payers referenced in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context and service setting, coverage and reimbursement benchmarks where available, common administrative considerations for claims, and coding relationships to related otologic procedures. The publication highlights procedural intent, typical sites of service, and implications for surgical specialty billing. Where specific input fields were not provided, the report notes that detailed payer-specific rates, related CPT/HCPCS crosswalks, and ICD-10 diagnosis mappings are not available in the input. This summary is written for a national audience and frames CPT code 69905 within clinical practice and billing workflow contexts.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 69905labyrinthectomyotologysurgical codingvestibular surgeryoperating room proceduresambulatory surgery centerneurotologyprocedure coding

Billing Code Overview

CPT code 69905 describes the surgical excision of the labyrinth, a destructive procedure that removes the semicircular canals, the utricle, and the saccule to extract the diseased labyrinth from the remaining vestibular system. This is an operative otologic procedure intended to eliminate pathologic vestibular structures when preservation of inner-ear vestibular function is not possible or indicated.

Service type: Surgical — otologic/excision procedure

Typical site of service: Hospital operating room or ambulatory surgical center, performed by otolaryngology (ENT) or neurotology surgical teams.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with longstanding, refractory unilateral Ménière disease or intractable vestibular vertigo resulting in disabling imbalance and recurrent vertiginous attacks despite maximal medical therapy (diuretics, salt restriction, vestibular suppressants, intratympanic therapy). The patient has failed less destructive interventions (vestibular rehabilitation, intratympanic gentamicin) and elects definitive surgical ablation. Preoperative workup includes audiometry, vestibular testing (videonystagmography, caloric testing), MRI to exclude retrocochlear pathology, and counseling regarding expected loss of residual vestibular function and possible hearing loss. The procedure, excision of the labyrinth (69905), is performed in an operating room under general anesthesia by an otolaryngologist—neurotologist or otologic surgeon—with intraoperative monitoring as indicated. Postoperative care includes inpatient observation for balance rehabilitation, vestibular suppressant weaning, pain control, and outpatient vestibular therapy. Billing is facility and professional components as appropriate; documentation must support medical necessity, prior conservative management, informed consent about permanent vestibular loss, and intraoperative findings.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Use when no specific modifier applies and full service performed.

CPT 69910: Excision of Labyrinth (Labyrinthectomy)

CPT-69915-VESTIBULAR-NERVE-SECTION-TRANSLABYRINTHINE-APPROACH

CPT 69915: Vestibular Nerve Section, Translabyrinthine Approach

Taxonomy Code	Specialty	Notes
207K00000X	Otology & Neurotology	Specialists in ear surgery who commonly perform labyrinth excision.
207L00000X	Otolaryngology	General ENT surgeons who perform complex ear procedures.
2080P0206X	Otolaryngology - Head & Neck Surgery	Head and neck surgeons with otologic expertise may be involved.
2084P0800X	Neurological Surgery	In complex skull base cases requiring neurosurgical collaboration.
2085R0202X	Plastic and Reconstructive Surgery	Occasionally involved for complex reconstructive needs of temporal bone wounds.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H81.0`	Ménière disease	Primary indication for definitive labyrinth excision when refractory to medical therapy.
`H81.3`	Benign paroxysmal vertigo	May lead to consideration of ablative surgery when persistent and disabling, rarely.
`H81.1`	Benign paroxysmal positional vertigo (BPPV)	Generally treated non-surgically; included when positional vertigo is refractory and differential diagnosis considered.
`H81.2`	Vestibular neuronitis	May be part of differential; chronic disabling cases could prompt surgical consideration in rare scenarios.
`H83.1`	Labyrinthitis	Chronic suppurative or intractable labyrinthitis with destructive disease may require excision.
`H91.90`	Unspecified hearing loss, unspecified ear	Hearing loss often accompanies labyrinth disease and is discussed in surgical planning.
`G45.9`	Transient cerebral ischemic attack, unspecified	Included for completeness when central causes of vertigo must be excluded prior to ablative surgery.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`69990`	Surgical exploration of posterior fossa with or without cranial nerve repair; incidental procedures	May be performed if surgical exposure extends to posterior fossa or unexpected intracranial findings occur.
`61582`	Translabyrinthine approach for resection of acoustic neuroma; small to medium tumor	Related skull base approach that also involves the labyrinth; codes may be used in tumor cases where labyrinth is removed.
`69320`	Mastoidectomy, with exploration and decompression of facial nerve when performed; with tympanoplasty	Often performed concurrently or prior to labyrinth excision for access to the inner ear structures.
`69930`	Excision of lesion of labyrinth (other than excision for acoustic neuroma)	Alternative or adjunct code for specific lesion excisions within the labyrinth; may be considered depending on operative detail.
`69990`	Unlisted procedure, nervous system	Use when a procedure does not have a more specific code; rarely needed if `69905` does not fully describe the service.
`92560`	Acoustic immittance testing	Perioperative diagnostic testing used pre- and post-operatively to assess middle ear function and aid surgical planning.

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