CPT 69310 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 69310 by major payers:
$1,467.65
$1,397.31
$1,493.00
$1,840.73
| 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 69310 | ||||||
United | 69310 | $2983.00 | 1275774747 - CHRISTIANA SPINE AMBULATORY SURGICAL CENTER, LLC | 263859264 - (DE) CHRISTIANA SPINE AMBULATORY SURGICAL CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $3424.00 | 1154326650 - SCOTTSDALE SURGICAL PARTNERS LLC, NORTH VALLEY SURGERY CENTER | 201808351 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $2560.00 | 1093748527 - WOODHAMS LASER & LENS IMPLANT CENTER LLC | 582631668 - (GA) WOODHAMS LASER LENS IMPLANT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $2814.00 | 1295279586 - UNIVERSITY OF MIAMI, UMIAMI MEDICINE - OPHTHALMOLOGY (NAPLES BASCOM PALMER - ASC) | 592579938 - UNIVERSITY OF MIAMI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $3095.00 | 1659113207 - WILMINGTON ASC LLC | 870883587 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $5249.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $2171.00 | 1477619005 - SOUTHWEST IDAHO SURGERY CENTER, INC. | 841394136 - (ID) SOUTHWEST IDAHO SURGERY CENTER INC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $1703.00 | 1780021188 - ENDOSCOPY CENTER OF NIAGARA, LLC | 453630889 - (NY) ENDOSCOPY CENTER OF NIAGARA LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $2800.00 | 1740561018 - CHILDREN 1ST GRAND PRAIRIE, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 453126800 - (TX) FIDUCIARY WISE, LLC FBO CHILDREN 1ST DENTAL & SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $1180.00 | 1295710317 - CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC | 203520333 - (FL) CENTRAL FLORIDA ENDOSCOPY SURGICAL INSTITUTE OF OCALA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $710.00 | 1669772893 - ADVANCED EYE SURGERY CENTER, L.L.C. | 273717607 - (KS) ADVANCED EYE SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $1581.00 | 1043283294 - THE HUTCHINSON OPHTHALMOLOGY ASC LLC, SURGERY CENTER OF SOUTH CENTRAL KANSAS | 621822845 - (KS) THE HUTCHINSON OPHTHALMOLOGY ASC LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $2308.00 | 1689852618 - MILLARD FILLMORE SURGERY CENTER, LLC | 261582864 - (NY) MILLARD FILLMORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $4781.00 | 1548784556 - NORTH ATLANTIC SURGICAL SUITES, LLC | 821540859 - (NH) NORTH ATLANTIC SURGICAL SUITES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69310 | $3300.00 | 1417304171 - COLLIN COUNTY ASC, LP, MEDFINITY HEALTH SURGERY CENTER - PLANO | 475615966 | TX | 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 69310 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69310 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 69310 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 |
|---|---|---|
| 69220-CPT | Low | Debride Mastoidect Cav Simpl Unilat |
| 69300-CPT | Moderate | Otoplasty W/Wo Size Reduc Unilat |
| 69310-CPT | High | Reconstruction Of External Auditory Canal (Meatoplasty) (Eg, For Stenosis Due To Trauma, Infection), (Separate Procedure |
| 69320-CPT | High | Reconstruc.Exter.Aud.Canal-Congen.Atresi |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69310. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69310 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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