Coding Ahead
CasePilot
Medical Coding Assistant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 69717 involves the replacement of an osseointegrated implant in the skull, which includes the removal of an existing device and the installation of a new one. This type of implant is typically used in patients who require a bone conduction implant (BCI) for auditory purposes, particularly when traditional hearing aids are not suitable. The procedure is performed when there are complications such as trauma or chronic inflammation at the site of the existing implant abutment. The process begins with the preparation of the surgical site, which includes shaving the hair behind the ear and marking the new recipient site for the implant. The surgical team carefully measures and marks the location for the transducer, ensuring precise placement for optimal function. The procedure requires meticulous dissection to access the implant site, removal of the existing device, and careful drilling to prepare the new site for the implant. The final steps involve securing the new implant and ensuring that it is properly positioned to allow for the attachment of an external speech processor, which is essential for the device's functionality. This procedure is critical for restoring hearing capabilities in patients who have experienced complications with their previous implants.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 69717 is indicated for patients who require the replacement of an osseointegrated implant in the skull due to specific complications. These indications include:

  • Trauma: Situations where the existing implant has been compromised due to physical injury.
  • Chronic Inflammation: Ongoing inflammatory conditions affecting the abutment site that necessitate the removal and replacement of the implant.

2. Procedure

The procedure for CPT® Code 69717 involves several detailed steps to ensure the successful replacement of the osseointegrated implant:

  • Step 1: The surgical site is prepared by shaving the hair behind the ear. The intended new recipient site for the implant is then measured and marked using a template to ensure accurate placement.
  • Step 2: The transducer location is marked with ink, and a needle is inserted into the bone to assist in identifying the correct position for the new implant.
  • Step 3: An incision is made, and dissection is performed down to the subpericranium to access the existing implant abutment, which is then removed.
  • Step 4: The bone surrounding the osseointegrated implant is drilled to facilitate the removal of the device. The surgical team inspects the wound to assess the reason for the complication that necessitated the replacement.
  • Step 5: The new implant site is identified, and dissection is performed to the pericranium, which is incised and dissected off the cranial bone to prepare for the new implant.
  • Step 6: A new guide hole is drilled at the new site, using depth-gauging drill bits to ensure that the bone thickness is appropriate for creating a seating well without risking contact with the dura or sigmoid sinus.
  • Step 7: Once the correct depth is determined, the final guide hole is widened with a spiral drill to create a larger opening for the implant seating.
  • Step 8: The new device is installed in the cranial bone, ensuring it is set according to specific requirements for optimal function.
  • Step 9: For implants that do not have a precoupled abutment, the transcutaneous abutment is snapped into place onto the implant.
  • Step 10: The flap and soft tissue around the abutment are thinned to the maximum thickness that will allow for transcutaneous attachment to the external speech processor.
  • Step 11: Finally, the site is closed in layers, with the abutment protruding through the soft tissue flap to allow for the external speech processor to be attached.

3. Post-Procedure

Post-procedure care for patients undergoing the replacement of an osseointegrated implant includes monitoring the surgical site for signs of infection or complications. Patients are typically advised on how to care for the area around the abutment and the external speech processor. Follow-up appointments are essential to assess the healing process and ensure the proper functioning of the implant. Patients may also receive instructions regarding activity restrictions to promote optimal recovery and prevent any undue stress on the surgical site.

Short Descr RPLCMT OI IMPLT SKL PRQ ESP
Medium Descr RPLCMT OI IMPLT SKULL PERQ ATTACHMENT ESP
Long Descr Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 26 - Other therapeutic ear procedures
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
E2 Lower left, eyelid
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
Date
Action
Notes
2023-01-01 Changed Code description changed.
2022-01-01 Changed Code description changed.
2001-01-01 Added First appearance in code book in 2001.
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"