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    v1.0.31
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l8613-ossicula-implant-ossiculoplasty
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    HCPCS L8613: Ossicula Implant

    HCPCS Level II code L8613 describes an ossicula implant, a prosthetic device used to replace or reconstruct the small bones of the middle ear (ossicles) to restore sound conduction; this code represents the supply or implantation of the ossicular prosthesis typically associated with otologic surgery performed in an operating room or other surgical setting such as an ambulatory surgery center.

    For related coverage guidance, see recent payer policy updates: Speech Therapy for Autism Disorders - Medical Policy, Physical Performance Test or Measurement, Sensory Integration Therapy and Auditory Integration Training.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult presenting with conductive hearing loss, chronic otitis media with ossicular erosion, or ossicular discontinuity following trauma or prior middle ear surgery. The otologic surgeon evaluates the patient with audiometry (air and bone conduction thresholds), tympanometry, and high-resolution CT of the temporal bones demonstrating ossicular chain damage or absence of ossicles. In the operating room under general anesthesia within an ambulatory surgery center or hospital outpatient department, the surgeon performs a tympanoplasty and places an ossicular implant (L8613) to reconstruct the ossicular chain (e.g., partial or total ossicular replacement prosthesis). Intraoperative steps include middle ear exploration, removal of diseased ossicular remnants, sizing and placement of the ossicular implant, and verification of stability and mobility of the prosthesis. Postoperative care includes audiometric follow-up, wound care, and monitoring for complications such as prosthesis displacement, infection, or persistent conductive hearing loss. Typical sites of service are outpatient surgery centers, hospital operating rooms, and occasionally inpatient otologic surgery when comorbidities require admission.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    69631Tympanoplasty, any method, with exploration of middle ear and removal of diseased tissue; with ossicular chain reconstruction when performedOften performed concurrently when placing an ossicular implant to repair middle ear pathology and restore conductive mechanism.
    69510Tympanotomy (e.g., for exploration and removal of foreign body), with insertion of tympanostomy tubeMay be performed in conjunction with middle ear access procedures when ventilation or drainage is required prior to definitive ossicular reconstruction.
    69210Removal of impacted cerumen (for ear canal preparation)Performed preoperatively or in clinic to allow otologic examination and ensure clear access for surgical planning.
    69990Unlisted procedure, nose, mouth and pharynx (used rarely for novel middle ear devices)Reserved only if an ossicular implant procedure or device does not have a specific applicable CPT and additional coding justification is provided.
    92587Tympanometry and reflex threshold measurementsPerformed pre- or postoperatively to assess middle ear function and monitor ossicular implant outcomes.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Y00000X
    207K00000X
    208M00000X
    163W00000X
    3336C0002X
    246YC3302X
    207XP3100X
    207ZH0000X

    Related ICD-10-CM Codes

    15 rows

    ICD-10-CM CodeDescription
    H81.10Benign paroxysmal vertigo, unspecified ear
    H81.11Benign paroxysmal vertigo, right ear
    H81.12Benign paroxysmal vertigo, left ear
    H81.13Benign paroxysmal vertigo, bilateral
    H83.09Labyrinthitis, unspecified ear
    H83.19Labyrinthine fistula, unspecified ear
    H90.11Conductive hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side
    H90.12Conductive hearing loss, unilateral, left ear, with unrestricted hearing on the contralateral side
    H90.3Sensorineural hearing loss, bilateral
    H90.41Sensorineural hearing loss, unilateral, right ear, with unrestricted hearing on the contralateral side

    Showing 1–10 of 15

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    10 rows

    PolicyPayerEffective Date
    Speech Therapy for Autism Disorders - Medical PolicyHealth-New-England2026-12-01
    Physical Performance Test or MeasurementCigna2026-11-15
    Sensory Integration Therapy and Auditory Integration TrainingColorado Rocky Mountain Health Plans2026-11-01
    Chiropractic Careexcellus_health_plan_inc2026-10-22
    Skilled Nursing and Skilled Rehabilitation Services (Outpatient)Anthem2026-10-01
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only)UnitedHealthcare2026-10-01
    Physical Therapy/Medicine Corporate Medical Policybcbsvermont2026-10-01
    Occupational Therapy Corporate Medical Policybcbsvermont2026-10-01
    Speech Language Pathology/Therapy Services Corporate Medical Policybcbsvermont2026-10-01
    Cognitive Rehabilitation Corporate Medical Policybcbsvermont2026-10-01

    Related Codes

    HCPCS-L5000-PARTIAL-FOOT-SHOE-INSERT-LONGITUDINAL-ARCH-TOE-FILLER

    HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

    HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

    HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

    HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

    HCPCS L5020: Partial Foot Molded Socket with Toe Filler

    HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

    HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

    HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

    HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

    HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

    HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

    HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

    HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

    HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

    HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

    HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

    HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

    HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

    HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

    Showing 1–10 of 472

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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