CPT 69205 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 69205 |
National average reimbursement for CPT 69205 by major payers:

$133.90

$128.62

$137.08

$163.94
| 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 69205 | ||||||
United | 69205 | $400.00 | 1083898605 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE, LLC, MIDSOUTH PAIN TREATMENT CENTER, LLC | 261545635 - MIDSOUTH INTERVENTIONAL PAIN INSTITUTE LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $1288.00 | 1225452303 - MARTHA JEFFERSON HOSPITAL, MARTHA JEFFERSON OUTPATIENT SURGERY CENTER | 540261840 - (VA) MARTHA JEFFERSON HOSPITAL | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $1258.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $2923.75 | 1003807835 - LAKEVIEW SURGERY CENTER LC | 421516120 - (IA) LAKEVIEW SURGERY CENTER LC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $496.00 | 1831371749 - PRISTINE SURGERY CENTER, INC | 272067985 - (CA) PRISTINE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $928.00 | 1760907919 - BANNER SUN CITY WEST SURGERY CENTER LLC | 901182684 - (AZ) BANNER SUN CITY WEST SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $436.00 | 1548263619 - AZAR EYE SURGERY CENTER LLC | 522325381 - (MD) AZAR EYE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $1179.00 | 1134262868 - NORTH SHORE SAME DAY SURGERY LLC, NORTH SHORE SURGICAL CENTER | 364120432 - (IL) NORTH SHORE SAME DAY SURGERY LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $496.00 | 1851638860 - WENATCHEE VALLEY HOSPITAL, CONFLUENCE HEALTH MOSES LAKE ASC | 455563741 - WENATCHEE VALLEY HOSPITAL | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $750.00 | 1154718070 - FERTILITY LAB SCIENCES OF MINNEAPOLIS, LLC | 465432360 - (MN) FERTILITY LAB SCIENCES OF MINN | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $1196.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $461.00 | 1306214705 - GSI ASC, LLC | 474883816 - (OK) GSI ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $173.19 | 1891224200 - KYLE KOPATICH | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 69205 | $545.00 | 1225077241 - CORTEZ FOOT SURGERY CENTER, P.A. | 650064196 - (FL) CORTEZ FOOT SURGERY CENTER PA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69205 | $496.00 | 1639149255 - COLD SPRINGS MEDICAL SURGICAL GROUP LLC, DE LA VINA SURGICENTER | 770521530 - (CA) COLD SPRINGS MEDICAL SURGICAL GROUP | CA | 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 69205 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69205 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 69205 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 69205. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69205 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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