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CPT 69005 Fee Schedule

Last Verified: February 2026

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 Ear Abscess/Hematoma Complex
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
Medicare Fee ScheduleView Medicare rates for 69005

National average reimbursement for CPT 69005 by major payers:

bcbs

$271.82

uhc

$274.78

aetna

$293.66

cigna

$359.87

Preview provider-level rates for...
For billing codeCPT 69005
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 69005

United
69005$667.001902447386 - SEATTLE PAIN RELIEF PLLC, FEDERAL WAY AMBULATORY SURGICAL FACILITY455527273 - (WA) SEATTLE PAIN RELIEF PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$667.001114990231 - SURGERY CENTER OF MIDDLE TENNESSEE LLC, THE SURGERY CENTER OF MIDDLE TENNESSEE621839266 - (TN) SURGERY CENTER OF MIDDLE TENNESSEE LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$3316.001063757227 - PARKVIEW ORTHO CENTER, LLC611697669 - (IN) PARKVIEW ORTHO CENTER LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$2392.001851887863 - TEXAS HEALTH SURGERY CENTER IRVING, LLC831085415TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$610.001770223901 - PSA AMBULATORY SURGICAL CENTER OF SOUTH AUSTIN, LLC874341110 - (TX) PSA AMBULATORY SURGICAL CENTER OF SOUTH AUSTIN LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$720.001457345530 - SYRINGA SURGICAL CENTER200968551 - (ID) SYRINGA SURGICAL CENTER, LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$1343.001144312075 - GATEWAY AMBULATORY SURGERY CENTER LLC, GATEWAY SURGERY CENTER202106989 - (NC) GATEWAY AMBULATORY SURGERY CENTERNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$570.001720359151 - ST JOHN SURGERY CENTER INC454271780 - (CA) ST JOHN SURGERY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$1196.001609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$563.501679612253 - WALKER SURGICAL CENTER LLC810635117 - (MI) WALKER SURGICAL CENTER LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$1367.001356965750 - PROLIANCE SURGERY CENTER AT VALLEY, LLC842108616 - (WA) PROLIANCE SURGERY CENTER AT VALLEY LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$2137.001063442077 - INOVA LOUDOUN AMBULATORY SURGERY203523190 - (VA) INOVA LOUDOUN AMBULATORY SURGERYVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$1134.001174999700 - ADVANCED SURGERY CENTER OF CENTRAL IOWA, LLC472673565 - (IA) ADVANCED SURGERY CENTER OF CENTRAL IOWA LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$515.001609874254 - NOVAMED SURGERY CENTER OF MERRILLVILLE, LLC223871351INAmbulatory Surgical Clinic/Center (261QA1903X)
United
69005$916.001902043284 - AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE911886576 - (WA) ELIE LEVY, M.D., P.C. DBA AESTHETIC & GENERAL DERMATOLOGY OF SEATTLEWAAmbulatory 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 69005 vs. Other Surgical Procedures on the Auditory System Codes

The CPT 69005 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 69005 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 69005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 69005 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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