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CPT 69000 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Drain Exter.Ear,Abscss/Hematma;Smpl
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Auditory System

Common Place of Service

11 - Office

23 - Emergency Room

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelModerate

National average reimbursement for CPT 69000 by major payers:

bcbs

$233.72

uhc

$235.45

aetna

$250.84

cigna

$307.07

Preview provider-level rates for...
For billing codeCPT 69000
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 69000

United
69000$360.001164930731 - REMBRANDT OUTPATIENT SURGERY CENTER PLLC, REMBRANDT OUTPATIENT SURGERY CENTER822368976 - (AZ) REMBRANDT OUTPATIENT SURGERY CENTER PLLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$500.001346773421 - WOMEN'S CARE FLORIDA LLC, WOMEN'S CARE FLORIDA SURGICAL CENTER823481913FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$482.001902863723 - OAK & MAIN SURGICENTER LLC223532371 - (NJ) OAK MAIN SURGICENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$301.001205266632 - ARKANSAS RENAL GROUP PA, OUACHITA PROCEDURE CENTER453592104 - (AR) ARKANSAS RENAL GROUP PAARAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$1129.001992752224 - SPRINGFIELD CLINIC LLP, SPRINGFIELD CLINIC AMBULATORY SURGERY CENTER370701328 - (IL) SPRINGFIELD CLINIC, LLPILAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$383.001811534555 - MIDLANTIC UROLOGY SURGERY CENTER, LLC825347080 - (PA) MIDLANTIC UROLOGY SURGERY CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$1500.001518057546 - LONG ISLAND AMBULATORY SURGERY CENTER, LLC200369668 - (NY) LONG ISLAND AMBULATORY SURGERY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$342.001831116698 - LASER AND OUTPATIENT SURGERY CENTER LLC201098451 - (FL) LASER AND OUTPATIENT SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$542.001700842507 - ARCADIA OUTPATIENT SURGERY CENTER LP752285078 - (CA) ARCADIA OUTPATIENT SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$475.001174938344 - SPECIALTY SURGERY CENTER, LLC455554765 - (MS) SPECIALTY SURGERY CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$973.001346508520 - FIRST GI ENDOSCOPY AND SURGERY CENTER LLC270870899 - (NJ) FIRST GI ENDOSCOPY AND SURGERY CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$417.001235104738 - THE OVERLAND PARK KS ENDOSCOPY ASC LLC, ENDOSCOPIC IMAGING CENTER201635603 - (KS) THE OVERLAND PARK KS ENDOSCOPY ASC LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$375.001629181136 - JOON Y. KIM, MD, PC, CLAYTON CATARACT & LASER SURGERY CENTER581603174GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$3000.001427585280 - PINNACLE SURGERY CENTER, INC812354493 - (CA) PINNACLE SURGERY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69000$675.001689349219 - EVEREST ASC861747710 - (ID) EVEREST ASCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 69000 vs. Other Surgical Procedures on the Auditory System Codes

The CPT 69000 code is part of the Surgery services used for Surgical Procedures on the Auditory 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 69000 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.

CodeComplexityDescription
69000-CPTModerateDrain Exter.Ear,Abscss/Hematma;Smpl
69005-CPTModerateDrain Ear Abscess/Hematoma Complex
69020-CPTModerateI & D Exter.Auditory Canal,Abscess
69100-CPTLowBiopsy External Ear

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 69000 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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