Data Platform
Sign InTry for Free

CPT 69100 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.

Biopsy External Ear
Key FactDetail
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 LevelLow
Medicare Fee ScheduleView Medicare rates for 69100

National average reimbursement for CPT 69100 by major payers:

bcbs

$120.33

uhc

$127.17

aetna

$132.73

cigna

$162.51

Preview provider-level rates for...
For billing codeCPT 69100
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 69100

United
69100$312.001487821633 - PACIFIC CATARACT AND LASER INSTITUTE INC PC911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$180.001265964050 - SCHAUMBURG SURGERY CENTER, LLC813061805 - (IL) SCHAUMBURG SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$345.001922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$383.001992759930 - IDAHO SURGICENTER INC, IDAHO SURGICENTER SOUTH200049792 - (ID) IDAHO SURGICENTER INCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$81.001447279369 - EYE CENTER OF NORTH FLORIDA, P.A., THE LASER & SURGERY CENTER522107690 - (FL) EYE CENTER OF NORTH FLORIDA, P.A.FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$1471.001295748531 - THE EMORY CLINIC INC, EMORY CLINIC AMBULATORY SURGERY CENTER582030692 - EMORY UNIVERSITYGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$363.001053505511 - DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK, LLC260531425 - (NY) DIGESTIVE DISEASE CENTER OF CENTRAL NEW YORK LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$174.001164771762 - MARYLAND SPECIALTY SURGERY CENTER, LLC454793230 - (MD) MARYLAND SPECIALTY SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$171.361386091767 - DAVID CORADIN350593390 - DEACONESS HOSPITAL INCFLGeriatric Medicine (Internal Medicine) Physician (207RG0300X)
United
69100$171.361669630661 - ALEXANDER RADNOVICH350593390 - DEACONESS HOSPITAL INCINPsychiatry Physician (2084P0800X)
United
69100$129.001023373628 - EYES ON STARK SURGERY CENTER, LLC, VISTA SURGICAL CENTER451114025 - (OH) EYES ON STARK SURGERY CENTER, LLC DBA VISTA SURGICAL CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$77.001316976137 - CENTRAL MARYLAND ENDOSCOPY LLC201580201 - (MD) CENTRAL MARYLAND ENDOSCOPY LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$178.001518004696 - CENTURY CITY ENDOSCOPY, LLC954754975 - (CA) CENTURY CITY ENDOSCOPY LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$970.001720324296 - MT OGDEN UTAH SURGICAL CENTER LLC371705271UTAmbulatory Surgical Clinic/Center (261QA1903X)
United
69100$88.001609568922 - BETHESDA ENDOSCOPY CENTER, LLC521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLCMDAmbulatory 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

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 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.

CodeComplexityDescription
69000-CPTModerateDrain Exter.Ear,Abscss/Hematma;Smpl
69005-CPTModerateDrain Ear Abscess/Hematoma Complex
69090-CPTLowPiercing Of Ear
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 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 69100) and we'll show you how you compare in 15 minutes or less.