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Official Description

Removal, entire 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 69726 involves the complete removal of an osseointegrated implant from the skull, specifically designed for bone conduction hearing restoration. This type of implant, known as a bone conduction implant (BCI), is utilized to assist individuals with conductive or mixed hearing loss by amplifying and conducting sound vibrations through the bone directly to the cochlea. The BCI consists of an external speech processor that is attached to an implant that is anchored to the skull, typically located in the temporal bone behind the ear, at the same height as the top of the auricle. The removal of such an implant may be indicated for various reasons, including infection, instability, pain, trauma to the implant, or failure of the implant to properly osseointegrate with the surrounding bone. The procedure is performed under local anesthesia, ensuring that the patient remains comfortable while the surgical team carefully incises the skin over the implant, exposes the mastoid complex, and meticulously removes the implant while preserving surrounding tissues.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The removal of an osseointegrated implant from the skull, as described by CPT® Code 69726, is indicated under several circumstances. These include:

  • Infection The presence of an infection surrounding the implant may necessitate its removal to prevent further complications and promote healing.
  • Instability If the implant is found to be unstable, it may not function effectively, leading to the decision to remove it.
  • Pain Persistent pain associated with the implant can indicate complications that warrant its removal.
  • Trauma Any trauma to the implant may compromise its integrity, requiring surgical intervention for removal.
  • Failure to osseointegrate If the implant fails to properly integrate with the surrounding bone, it may need to be removed to address the issue.

2. Procedure

The procedure for the removal of the osseointegrated implant involves several critical steps, which are detailed as follows:

  • Step 1: Anesthesia Administration The procedure begins with the administration of local anesthesia to ensure the patient is comfortable and pain-free during the surgery.
  • Step 2: Incision and Exposure The skin overlying the implant is carefully measured, marked, and incised to provide access to the underlying structures. The mastoid complex is then exposed to facilitate the removal process.
  • Step 3: Flap Creation Skin and periosteal flaps are created to allow for adequate visualization and access to the implant site.
  • Step 4: Incision of Surrounding Tissue The subcutaneous tissue surrounding the implant is incised, which helps in mobilizing the implant for removal.
  • Step 5: Bone Drilling and Implant Removal The bone surrounding the implant is drilled out to free the implant from its bed. Once adequately loosened, the existing implant is carefully removed from the skull.
  • Step 6: Closure After the implant has been successfully removed, the surrounding soft tissues are closed over the wound to promote healing.

3. Post-Procedure

Post-procedure care following the removal of the osseointegrated implant is essential for recovery. Patients may experience some discomfort and swelling at the surgical site, which can be managed with prescribed pain relief medications. It is important for patients to follow their healthcare provider's instructions regarding wound care to prevent infection. Follow-up appointments may be scheduled to monitor the healing process and assess any further treatment options if necessary. Patients should also be advised to avoid strenuous activities during the initial recovery period to ensure proper healing.

Short Descr RMV NTR OI IMPLT SKL PRQ ESP
Medium Descr REMOVAL ENTIRE OI IMPLT SKL PERQ ATTACHMENT ESP
Long Descr Removal, entire 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 Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE 1
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).
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
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.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
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)
Date
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Notes
2023-01-01 Changed Code description changed.
2022-01-01 Added Code added
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