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Code deleted. To report mastoidectomy performed with osseointegrated surgery, see 69501-69676

Official Description

Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

An osseointegrated implant is a specialized device used to improve hearing in patients who experience hearing loss due to conditions affecting the middle ear and cochlea. The procedure described by CPT® Code 69718 involves the replacement of an existing osseointegrated implant in the temporal bone, which is a critical area of the skull that houses structures essential for hearing. This replacement procedure includes the removal of the current implant and the installation of a new one, which is then attached percutaneously to an external speech processor or cochlear stimulator. The process begins with careful measurement and marking of the skin over the implant site, followed by an incision to expose the mastoid complex. This exposure is crucial as it allows the surgeon to create skin and periosteal flaps, which facilitate access to the underlying bone. The existing implant is then removed after drilling out the surrounding bone, and the site is prepared to accommodate the new implant. The new implant is secured in place, and the skin flap is modified to allow for the attachment of the external device. This procedure is particularly significant for patients who have lost their hearing due to disease, as it aims to restore auditory function and improve quality of life.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 69718 is indicated for patients who have experienced hearing loss due to diseases affecting the middle ear and cochlea. The specific conditions that may warrant this procedure include:

  • Hearing Loss Patients suffering from significant hearing impairment resulting from conditions such as chronic otitis media, cholesteatoma, or other middle ear pathologies.
  • Failure of Conventional Hearing Aids Individuals who have not achieved satisfactory hearing improvement with traditional hearing aids may benefit from an osseointegrated implant.
  • Bone Conduction Hearing Loss Patients with conductive hearing loss or mixed hearing loss who are suitable candidates for bone conduction devices.

2. Procedure

The procedure for CPT® Code 69718 involves several critical steps to ensure the successful replacement of the osseointegrated implant:

  • Step 1: Preparation The surgical site is prepared by measuring and marking the skin over the existing implant. This ensures accurate incision placement for optimal access to the implant site.
  • Step 2: Incision and Exposure An incision is made in the marked area to expose the mastoid complex. This step is essential for accessing the underlying structures and allows the surgeon to create skin and periosteal flaps.
  • Step 3: Flap Creation Skin and periosteal flaps are carefully created to provide adequate access to the bone surrounding the implant. This involves mobilizing the tissue to expose the implant site fully.
  • Step 4: Removal of Existing Implant The subcutaneous tissue surrounding the existing implant is incised, and the bone is drilled out to facilitate the removal of the old implant. This step is crucial for preparing the site for the new device.
  • Step 5: Shaping the Implant Site The hole in the bone is shaped to accommodate the new osseointegrated implant, ensuring a proper fit and secure placement.
  • Step 6: Placement of New Implant The new implant is placed in the prepared site and secured in position, which is vital for the stability and functionality of the device.
  • Step 7: Attachment to External Device The skin flap is perforated to allow for the attachment of the external speech processor or cochlear stimulator, which is necessary for the device to function effectively.
  • Step 8: Closure The surrounding soft tissues are reduced in thickness to facilitate closure of the wound over the implant, ensuring that the site is properly healed and protected.

3. Post-Procedure

After the procedure, patients may require specific post-operative care to ensure proper healing and functionality of the new implant. This includes monitoring for any signs of infection at the surgical site, managing pain, and following up with audiological assessments to evaluate the effectiveness of the implant. Patients are typically advised on activity restrictions to avoid undue stress on the implant site during the initial healing phase. Additionally, instructions regarding the care of the external speech processor or cochlear stimulator will be provided to ensure optimal use and maintenance of the device.

Short Descr REVISE TEMPLE BONE IMPLANT
Medium Descr RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY
Long Descr Replacement (including removal of existing device), osseointegrated implant, temporal bone, with percutaneous attachment to external speech processor/cochlear stimulator; with mastoidectomy
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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 26 - Other therapeutic ear procedures
Date
Action
Notes
2021-12-31 Deleted Code deleted. To report mastoidectomy performed with osseointegrated surgery, see 69501-69676
2001-01-01 Added First appearance in code book in 2001.
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