CPT 69209 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 • 20 - Urgent Care Facility |
| Common Modifiers | • None • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 69209 by major payers:

$21.69

$17.85

$19.59

$34.90
| 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 69209 | ||||||
United | 69209 | $790.00 | 1366137440 - SURGERY CENTER OF GEORGETOWN, LLC, GEORGETOWN SURGERY CENTER | 880604963 - (TX) SURGERY CENTER OF GEORGETOWN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $144.00 | 1710151063 - HENDI AMBULATORY SURGERY CENTER, PC | 262238944 - (MD) HENDI AMBULATORY SURGERY CENTER PC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $165.00 | 1437102241 - SURGERY CENTER OF FREMONT, LLC | 203639614 - (NE) SURGERY CENTER OF FREMONT LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $254.00 | 1982672283 - ROSEVILLE SURGERY CENTER, LP, ROSEVILLE SURGERY CENTER | 202468557 - (CA) ROSEVILLE SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $160.00 | 1154996361 - CHADDS FORD AMBULATORY SURGICAL CENTER, LLC | 831876495 - (PA) CHADDS FORD AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $555.00 | 1114302353 - POINT OF ROCKS SURGERY CENTER, LLC | 464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $344.00 | 1821361130 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC SHOWLOW | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $125.00 | 1396727418 - ENDOSCOPY CENTER OF LITTLE ROCK,LLC, RIC LR LLC | 20703428 - (AR) ENDOSCOPY CENTER OF LITTLE ROCKLLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $90.00 | 1649443367 - SKIN SURGERY CENTER OF VIRGINIA | 262319829 - (VA) SKIN SURGERY CENTER OF VIRGINIA | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $345.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $125.00 | 1376501064 - SOUTH CENTRAL SURGICAL CENTER, LLC, CENTER FOR SPECIALTY CARE | 411952256 - (MN) SOUTH CENTRAL SURGICAL CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $840.00 | 1447457403 - BERGEN GASTROENTEROLOGY PC | 222713168 - (NJ) BERGEN GASTROENTEROLOGY, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $87.00 | 1922071315 - SENECA PA ASC LLC, THE SURGERY AND LASER CENTER | 621806254 - (PA) SENECA PA ASC, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $725.00 | 1992788384 - ASPEN SURGERY VENTURE LLC, ASPEN SURGERY CENTER | 263913327 - (CA) ASPEN SURGERY VENTURE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69209 | $85.00 | 1235239054 - MAIN LINE PA ENDOSCOPY ASC LP, MAIN LINE ENDOSCOPY CENTER BALA CYNWYD | 205301211 | PA | 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 69209 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69209 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 69209 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 69209. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69209 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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