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CPT®
69840

CPT® Code 69840
Deleted

Official Description

Revision fenestration operation

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 69840 refers to a revision fenestration operation, which is a surgical procedure aimed at modifying or correcting a previously performed fenestration of the semicircular canal. Fenestration procedures were historically utilized to address conductive hearing loss by creating an opening in the semicircular canal, allowing sound to bypass the stapes footplate and facilitating sound transmission to the cochlea. The procedure typically involves a transmastoid approach, where the mastoid bone is accessed through the ear canal. During the initial fenestration, a small hole is created in the lateral semicircular canal, and a fascial graft is placed over this opening to maintain its function. In the case of CPT® Code 69840, the focus is on revising an existing fenestration, which may include reopening the original fenestration site, replacing the graft, or potentially creating a new fenestration if necessary. This procedure is less common in contemporary practice compared to its historical use, reflecting advancements in treatment options for hearing loss.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The revision fenestration operation (CPT® Code 69840) is indicated for patients who have previously undergone a fenestration procedure and are experiencing complications or inadequate results from the initial surgery. The specific indications for this procedure may include:

  • Failure of Initial Fenestration - The original fenestration may not have achieved the desired improvement in hearing, necessitating a revision.
  • Graft Complications - Issues such as graft failure or retraction may require replacement or adjustment of the fascial graft.
  • Changes in Patient Condition - New developments in the patient's hearing status or anatomical changes may warrant a revision of the fenestration.

2. Procedure

The revision fenestration operation involves several key procedural steps, which are detailed as follows:

  • Step 1: Anesthesia Administration - The procedure begins with the administration of appropriate anesthesia to ensure the patient is comfortable and pain-free during the operation.
  • Step 2: Accessing the Mastoid - A transmastoid approach is utilized, where the surgeon makes an incision behind the ear to access the mastoid bone. This may involve performing a mastoidectomy using a wall down technique, which entails removing bone to create a single cavity that includes both the mastoid and the ear canal.
  • Step 3: Identifying the Existing Fenestration - The surgeon carefully locates the previously created fenestration in the lateral semicircular canal. This step is crucial for determining the necessary revisions.
  • Step 4: Revising the Fenestration - Depending on the condition of the existing fenestration, the surgeon may choose to reopen the original fenestration, replace the fascial graft, or create a new fenestration if the original site is not viable.
  • Step 5: Closure - After the necessary revisions are made, the surgical site is closed, and the incision behind the ear is sutured to promote healing.

3. Post-Procedure

Post-procedure care following a revision fenestration operation typically includes monitoring the patient for any immediate complications, managing pain, and providing instructions for recovery. Patients may be advised to avoid strenuous activities and to follow up with their healthcare provider for assessment of hearing improvement and healing of the surgical site. It is essential to monitor for any signs of infection or complications related to the graft or fenestration site during the recovery period.
Short Descr REVISE INNER EAR WINDOW
Medium Descr REVISION FENESTRATION OPERATION
Long Descr Revision fenestration operation
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) 2 - Payment restriction for assistants at surgery does not apply 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
2017-12-31 Deleted Code deleted.
Pre-1990 Added Code added.
Code
Description
Code
Description
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