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See a sample rate comparisonCPT 69100 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.
Biopsy External Ear
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Auditory System |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 69100 |
| Medicaid Fee Schedule | View Medicaid rates for 69100 |
National average reimbursement for CPT 69100 by major payers:
$120.33
$127.17
$132.73
$158.30
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CPT 69100
5 of 25 sample ratesHigher to lower in this preview
Hss Asc Of Manhattan LLC, Hss Asc Of Manhattan
$2,202.00Published rateDigestive Disease Center Of Central New York, LLC
Digestive Disease Center Of Central New York LLC
$363.00Published rateSchaumburg Surgery Center, LLC
Schaumburg Surgery Center LLC
$180.00Published rateM. Reza Mizani, M.D., P.A., Total Vascular Care
M. Reza Mizani Md, PA
$150.00Published rateNewsom Surgery Center Of Sebring LLC
$76.00Published rate
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See a sample payer proposalCPT 69100 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69100 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 69100 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. |
| 69090-CPT | Low | Cosmetic Ear Piercing, A Standard Ear Piercing With A Sterile Needle Or Piercing Gun Performed By A Medical Professional. |
| 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 69100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69100 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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