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Official Description

Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 69730 refers to the surgical procedure for the replacement of an osseointegrated implant in the skull, which includes the removal of an existing device. This procedure specifically involves the use of a magnetic transcutaneous attachment to an external speech processor, which is positioned outside the mastoid area. The procedure is indicated for patients with a bony defect that has a surface area of 100 square millimeters or greater, extending deep to the outer cranial cortex. Bone conduction implants (BCI) are designed to enhance hearing by utilizing an external hearing aid or speech processor that amplifies sound. The BCI is anchored to the skull, allowing sound vibrations to be transmitted through the bone directly to the cochlea, which is essential for individuals with certain types of hearing loss. The magnetic transcutaneous attachment is particularly beneficial in cases where the mastoid region is compromised, such as in patients suffering from chronic infections that affect hearing. The replacement of the device may be necessary in instances of malfunction, ensuring continued functionality and effectiveness of the hearing aid system. The surgical approach is meticulously planned, typically behind the ear in the retrosigmoid area or the squamous part of the temporal bone, to facilitate optimal placement and integration of the new implant.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 69730 is indicated for patients who require a replacement of an osseointegrated implant due to various conditions affecting the mastoid area and the functionality of the existing device. The specific indications include:

  • Chronic Infection - Patients with chronic infections that compromise the mastoid area, leading to hearing loss.
  • Malfunction of Existing Device - Situations where the current implant has failed or is malfunctioning, necessitating replacement.
  • Bony Defect - Cases where there is a significant bony defect (greater than or equal to 100 square millimeters) deep to the outer cranial cortex, which may affect the stability and effectiveness of the implant.

2. Procedure

The procedure for CPT® Code 69730 involves several detailed steps to ensure the successful replacement of the osseointegrated implant. The steps are as follows:

  • Preparation of the Surgical Site - The surgical site is planned behind the mastoid of the ear, specifically in the retrosigmoid area or the squamous part of the temporal bone. Hair is removed from the area to provide a clear field for surgery, and the site for the new implant is measured and marked. The transducer site is also marked using ink through a needle inserted into the bone.
  • Incision and Dissection - An incision is made at the marked site, and careful dissection is performed down to the subpericranium. This meticulous approach is crucial for the removal of the existing implant without causing damage to surrounding structures.
  • Inspection and Pocket Creation - The surgical site is inspected for any complications related to the previous implant. A subpericranial pocket is then created for the new implant coil and magnet, ensuring proper placement and integration.
  • Identification and Drilling - The new transducer site is identified and marked on the skull. Fixation holes are drilled carefully, avoiding critical structures such as the sigmoid sinus and dura mater over the temporal lobe. The depth of the site is measured to accommodate the fixation screw, and the skull is drilled to create a well of at least 100 square millimeters of surface area down to or beyond the inner cortex, while taking care to avoid injury to the facial nerve and large sigmoid sinus blood vessel.
  • Placement of the Device - The coil, magnet, and transducer components are placed into the well created in the bone. The entire device is then fixed to the skull using a fixation screw, which is set to a specific torque to ensure stability.
  • Closure of the Surgical Site - The thickness of the overlying skin flap is measured and carefully reduced to an optimal thickness for transcutaneous transmission. The wound is irrigated and closed in layers to promote healing and minimize complications.

3. Post-Procedure

After the procedure, the patient will undergo a recovery period during which the implant will begin to merge with the living tissue over several months. It is important for the patient to follow post-operative care instructions to ensure proper healing and integration of the implant. The external speech processor can be attached and detached from the implant via the magnet, allowing for ease of use and maintenance. Regular follow-up appointments may be necessary to monitor the healing process and the functionality of the implant.

Short Descr RPLC OI IMPLT SK TC ESP>=100
Medium Descr RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100
Long Descr Replacement (including removal of existing device), osseointegrated implant, skull; with magnetic transcutaneous attachment to external speech processor, outside the mastoid and involving a bony defect greater than or equal to 100 sq mm surface area of bone deep to the outer cranial cortex
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) none
MUE 1
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
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.)
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 Added Code added.
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