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See a sample rate comparisonCPT 69220 Fee Schedule
Last Verified: October 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.
Debride Mastoidect Cav Simpl Unilat
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Auditory System |
| Common Place of Service | 11 - Office 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 69220 |
| Medicaid Fee Schedule | View Medicaid rates for 69220 |
National average reimbursement for CPT 69220 by major payers:
$117.78
$127.98
$135.44
$98.96
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CPT 69220
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Texas International Endoscopy Center, LLC, Texas International Endoscopy Center
$1,831.00Published rateMason Ridge Ambulatory Surgery Center Lp, Gateway Endoscopy Center
$615.00Published rateSouthwestern Eye Center Ltd, Southwestern Eye Center
Southwestern Eye Center, Ltd.
$344.00Published ratePocono Ambulatory Surgery Center Ltd
$120.00Published rateDigestive Health Specialists, PA
Digestive Health Specialists, P.A.
$35.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 69220 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69220 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 69220 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.
| Code | Complexity | Description |
|---|---|---|
| 69110-CPT | Moderate | Excis External Ear;Part,Smpl Repair |
| 69209-CPT | Low | Removal Impacted Cerumen Using, Removal Impacted Cerumen Using Irrigationlavage Unilateral |
| 69210-CPT | Low | Remval Impacted Cerumen Requir Instrumentat Unilat, Removal Impacted Cerumen Requiring Instrumentation Unilateral |
| 69220-CPT | Low | Debride Mastoidect Cav Simpl Unilat |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69220 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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