CPT 69200 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Auditory System |
| Common Place of Service | • 11 - Office • 23 - Emergency Room • 20 - Urgent Care Facility |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 69200 by major payers:

$116.64

$123.21

$131.03

$149.09
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 69200 | ||||||
United | 69200 | $402.00 | 1912600826 - SURGICAL CENTER OF TVH | 882585662 - (ID) SURGICAL CENTER OF TVH | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $425.00 | 1578558078 - KINGSPORT ENDOSCOPY CORPORATION | 61249637 - (TN) KINGSPORT ENDOSCOPY CORPORATION | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $125.00 | 1245399757 - KUMAR SURGICAL CENTER LLC | 383530839 - (MI) KUMAR SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $325.00 | 1306135298 - DMG PAIN MANAGEMENT SURGERY CENTER, LLC | 271322187 - (IL) DMG PAIN MANAGEMENT SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $3146.00 | 1326046822 - SOUTH EMERSON SURGERY CENTER, LLC | 352087260 - (IN) SOUTH EMERSON SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $80.00 | 1639375108 - HEALING ARTS SURGERY CENTER INC | 204635621 - (CA) HEALING ARTS SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $300.00 | 1003079187 - WASC LLC | 205816792 - (OH) WOOSTER AMBULATORY SURGERY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $182.00 | 1720156482 - LASER & SURGICAL EYE CENTER LLC | 931194986 | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $574.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $355.00 | 1114312659 - UNITED SHOCKWAVE SERVICES, LTD., UNITED THERAPIES | 363415474 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $85.00 | 1235239054 - MAIN LINE PA ENDOSCOPY ASC LP, MAIN LINE ENDOSCOPY CENTER BALA CYNWYD | 205301211 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $300.00 | 1740289024 - KOOTENAI OUTPATIENT SURGERY CNTR LLC, KOOTENAI OUTPATIENT SURGERY | 820523354 - (ID) KOOTENAI OUTPATIENT SURGERY | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $164.00 | 1699711382 - TOWSON SURGICAL CENTER LLC, TOWSON SURGICAL CENTER | 521945958 - (MD) TOWSON SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $67.00 | 1386820694 - URO-CENTER AMBULATORY SURGICAL CENTER LLC | 522267795 - (MD) UROCENTER AMBULATORY SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69200 | $54.00 | 1548655053 - MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC | 463162562 - (MS) MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 69200 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69200 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 69200 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69200 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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