CPT CODESurgery (Endocrine/Nervous/Eye/Ear)Status A

CPT Code 69955Complete Billing & Coding Guide (2026)Release facial nerve

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$1707
Non-facility · National avg
Facility
$1707
Total RVU
51.12
Global
090
Payment
$1707
non-facility
Work RVU
28.68
physician effort
Global Period
090
post-op days
Bundling Edits
10
NCCI pairs

About CPT 69955

CPT 69955 is a Current Procedural Terminology code in the Surgery (Endocrine/Nervous/Eye/Ear) category maintained by the American Medical Association. The CMS short descriptor reads "Release facial nerve". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Major surgical codes carry a 90-day global period that bundles all related post-operative care. Improper billing of post-op E/M (without modifier 24 for unrelated care) is a common audit finding. Documentation of medical necessity for the procedure itself remains the foundation of any successful claim.

Pro Tip

CPT 69955 has a 90-day global period. Any E/M visit within that window for the same condition is bundled into the procedure payment. Use modifier 24 for unrelated E/M, modifier 79 for unrelated procedures, and modifier 78 for related returns to the OR.

Code Properties

Global Period
090
90-day global period
Status Indicator
A
Active. Payment under Medicare PFS.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
51.12 total RVU
28.68
18.26
Work RVU
28.68 · 56%
Physician time + skill
Practice Expense
18.26 · 36%
Office & equipment
Malpractice
4.18 · 8%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$1707.45
51.12 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$1707.45
51.12 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

Medicare Payment by State

Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.

AK
$2163
DC
$1884
NY
$1874
NJ
$1845
FL
$1842
IL
$1817
CT
$1803
WA
$1794
CA
$1790
MA
$1788
MD
$1757
HI
$1732

Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.

NCCI Bundling Edits

10 pairs

These codes trigger National Correct Coding Initiative edits when billed with 69955. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.

Common Denial Risk

Billing 69955 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.

AR Recovery Note

Multi-procedure NCCI edits hit surgical specialties harder than any other category. CO-97 denials on 69955 are frequently recoverable when the operative note documents distinct anatomic sites or staged steps. Our coders read the op note against the edit pair and pick the right modifier (XS preferred over modifier 59 for distinct structures).

Applicable Modifiers

Modifiers commonly paired with 69955 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

22
Increased procedural services — work substantially greater than typically required
When to use · When the work required for a procedure is substantially more than usual (e.g., morbid obesity, extensive adhesions, unusual anatomy). Request additional payment.
33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
50
Bilateral procedure — performed on both sides of the body during the same operative session
When to use · When a procedure is performed on both sides (e.g., bilateral knee injections, bilateral cataract surgery). Payment = 150% of unilateral rate.
51
Multiple procedures — when multiple procedures (other than E/M) are performed at the same session
When to use · Second and subsequent procedures during the same session. Payment is typically reduced to 50% for the 2nd procedure, 25% for the 3rd+.
52
Reduced services — when a procedure is partially reduced or eliminated at the physician's discretion
When to use · When a procedure is not completed to its full extent (e.g., incomplete colonoscopy that didn't reach cecum). Payment reduced by payer discretion.
53
Discontinued procedure — physician elected to terminate/discontinue a procedure due to patient risk
When to use · When a surgical procedure is started but discontinued due to patient safety concerns (e.g., anesthesia complications, intraoperative findings).
54
Surgical care only
When to use · When the surgeon provided ONLY the surgery, not pre/post op care
55
Postoperative management only
When to use · When you managed post-op but another physician performed the surgery
AR Recovery Note

Modifier 24, 79, 78, and 58 on global-period claims are the highest-recovery surgical billing levers. 69955 carries a 090 global indicator. Our team flags every encounter inside an active global period for the right modifier decision.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 69955 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Surgery (Endocrine/Nervous/Eye/Ear) claims. Our AAPC-certified team audits your last 90 days of 69955 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 69955

What does CPT code 69955 cover?

CPT 69955 is a Current Procedural Terminology code in the Surgery (Endocrine/Nervous/Eye/Ear) category maintained by the American Medical Association. The CMS short descriptor reads "Release facial nerve". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 69955?

The national average Medicare payment for CPT 69955 is approximately $1707.45 in a non-facility setting and $1707.45 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 51.12 with a conversion factor of $33.4009.

What is the global period for CPT 69955?

CPT 69955 has a 90-day global period (indicator 090). Routine post-op care for the next 90 days is bundled into the procedure payment, including all related E/M visits. Bill modifier 24 for unrelated E/M, modifier 79 for unrelated procedures, or modifier 78 for related returns to the OR during this window.

What codes bundle with CPT 69955?

CPT 69955 has NCCI Procedure-to-Procedure edits with 10+ codes including 0213T, 0216T, 0596T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.