CPT 69210 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 • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 69210 |
National average reimbursement for CPT 69210 by major payers:

$62.52

$62.55

$65.62

$79.08
| 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 69210 | ||||||
United | 69210 | $25.15 | 1245626670 - NEAL CARLIN | 223203133 - (NJ) DR RICARDO E RODRIGUEZ M D P A | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $85.31 | 1336311927 - MANISHA GROVER | 853737205 | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $23.70 | 1619924388 - ERINN BEAGIN | 834545753 - (NJ) PRINCETON INTERNAL MEDICINE AN | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $73.52 | 1851483754 - BENNY CHU | 223624559 - (NJ) RIVERSIDE MEDICAL GROUP | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $30.92 | 1801878582 - AHMAD MUR | 223822149 | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $30.92 | 1386671071 - LIN XU | 481300931 - (NJ) SOUTHSHORE MEDICAL ASSOCIATES LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $27.35 | 1891955811 - SIKIRU A. GBADAMOSI, M.D., LLC | 262027507 - (NJ) SIKIRU A GBADAMOSI MD LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $94.26 | 1154687374 - OMEGA BALL | 474931969 - (NJ) HUNTERDON PRIMARY CARE PC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $46.27 | 1326748500 - TRIDENT HEALTHCARE PC | 922154408 - (NJ) TRIDENT HEALTHCARE PC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $76.79 | 1952399420 - CHRISTOPHER FREER | 814786011 | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $32.81 | 1205818135 - NAZIA RIZVI | 262489199 - (NJ) PRIMARY HEALTHCARE LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $32.81 | 1699902296 - HECTOR AGUILAR | 204503813 - (NJ) PREMIER CARE ASSOCIATES OF WEST HUDSON | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $25.15 | 1851342703 - CARLOS TEJEDA | 463053927 - (NJ) CENTER FOR MED CARE PC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $25.76 | 1215974902 - EDWARD LAUB | 852854894 - (NJ) EDWARD LAUB MD LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 69210 | $25.15 | 1003867607 - KAUSALYA CHENNAPRAGADA | 221818699 - (NJ) NORTH HUDSON COMMUNITY ACTION CORPORATION | NJ | Internal Medicine Physician (207R00000X) |
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 69210 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69210 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 69210 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 69210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69210 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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