CPT 30469 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Respiratory System |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 30469 by major payers:
$2,856.05
$3,492.64
$3,275.11
$4,155.57
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 30469 | ||||||
United | 30469 | $1445.00 | 1801849427 - MAIN STREET ASC LLC, OPHTHALMIC ASSOCIATES SURGERY AND LASER CENTER | 383711415 - (PA) MAIN STREET ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $1550.00 | 1609399963 - INTERVENTIONAL SURGERY INSTITUTE OF WHITE HALL LLC | 814296629 - (AR) INTERVENTIONAL SURGERY INSTITUTE OF WHITE HALL LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $5249.00 | 1275198673 - UROLOGY ASC- PHOENIX, LLC, UROLOGIC SURGERY CENTER OF ARIZONA | 320586987 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $5433.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $4074.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $5249.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $3168.00 | 1578073631 - IREDELL PHYSICIAN NETWORK LLC, IREDELL AMBULATORY SURGERY CENTER | 263853529 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $1291.00 | 1558748996 - NEMG GASTROENTEROLOGY LLC, FAIRFIELD COUNTY ENDOSCOPY CENTER | 473578382 | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $1700.00 | 1407227358 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH SURGERY CENTER AT NORTHPOINT | 650592518 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $1836.00 | 1316926405 - MIRACLE HILLS SURGERY CENTER LLC | 204464406 - (NE) MIRACLE HILLS SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $6506.00 | 1194351833 - DELRAY BEACH ASC, LLC, DELRAY BEACH SURGERY CENTER | 843067076 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $2472.00 | 1912480070 - SOG SURGERY CENTER LLC | 822479805 - (MS) SOG SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $2849.00 | 1992451389 - NRH PAIN MANAGEMENT GROUP LLC, CASTLE SURGERY CENTER | 844029943 - (TX) NRH PAIN MANAGEMENT GROUP LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $932.00 | 1497740617 - LAKE COUNTY PAIN & DIAGNOSTIC | 651216636 - (OH) LAKE COUNTY PAIN DIAGNOSTIC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 30469 | $2800.00 | 1679963912 - FERTILITY LAB SCIENCES OF ORANGE COUNTY, LLC | 464731184 - (CA) FERTILITY LAB SCIENCES OF ORAN | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 30469 vs. Other Surgical Procedures on the Respiratory System Codes
The CPT 30469 code is part of the Surgery services used for Surgical Procedures on the Respiratory System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 30469 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 30468-CPT | High | Repair Of Nasal Valve Collapse With Subcutaneous/Submucosal Lateral Wall Implant -Deny Inv/N10>=1/1/2021 |
| 30469-CPT | High | Repair Of Nasal Valve Collapse With Low Energy, Temperature-Controlled Subcutaneous/Submucosal Remodeling - Deny Inv/N10>=12/31/2024 |
| 30520-CPT | Moderate | Septoplasty W/Wo Cartilage Implant |
| 30801-CPT | Moderate | Ablation, Soft Tissue Of Inferior Turbinates, Unilateral Or Bilateral, Any Method (Eg, Electrocautery, Radiofrequency Ablation, Or Tissue Volume Reduction); Superficial |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 30469. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 30469 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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