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See a sample rate comparisonCPT 69005 Fee Schedule
Last Verified: October 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 Infection From The Ear, Surgery To Drain Blood Pus Or Fluid From An Abscess (Pocket Of Infection) Or Hematoma (Collection Of Blood Under The Skin) Located In The Ear.
| Key Fact | Detail |
|---|---|
| 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 Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 69005 |
| Medicaid Fee Schedule | View Medicaid rates for 69005 |
National average reimbursement for CPT 69005 by major payers:
$271.82
$274.78
$293.66
$347.80
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CPT 69005
5 of 25 sample ratesHigher to lower in this preview
Endoscopy Surgery Center Of Silicon Valley LLC
$3,933.00Published rateGateway Ambulatory Surgery Center LLC, Gateway Surgery Center
Gateway Ambulatory Surgery Center
$1,343.00Published rateDallas Asc, LLC, North Park Heart & Vascular Surgery Center
$875.00Published rateGeorgia Vascular & Vein Center
Georgia Vascular Vein Center
$607.00Published rateAnwar Eye Center, Inc
Anwar Eye Center Inc
$358.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 69000-CPT | Moderate | Drain Infection From The Ear, Surgery To Drain Blood Pus Or Fluid From An Abscess (Pocket Of Infection) Or Hematoma (Collection Of Blood Under The Skin) Located In The Ear. |
| 69005-CPT | Moderate | Drain Infection From The Ear, Surgery To Drain Blood Pus Or Fluid From An Abscess (Pocket Of Infection) Or Hematoma (Collection Of Blood Under The Skin) Located In The Ear. |
| 69020-CPT | Moderate | Drain Infection From Ear Canal, Surgery To Drain Blood Pus Or Fluid From A Pocket Of Infection (Abscess) In The Ear Canal. |
| 69100-CPT | Low | Biopsy 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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