CPT 69436 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 • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 69436 by major payers:

$215.18

$208.37

$231.82

$269.29
| 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 69436 | ||||||
United | 69436 | $162.53 | 1518574789 - JONATHAN YOUNGBLOOD | 842136648 - (TX) ORTHOLONESTAR, PLLC | TX | Physical Therapist (225100000X) |
United | 69436 | $269.29 | 1316276744 - TEXAS HEALTH CARE, P.L.L.C. | 710892430 - (TX) TEXAS HEALTH CARE, P.L.L.C. | TX | Otolaryngology Physician (207Y00000X) |
United | 69436 | $359.66 | 1710158803 - ELIZABETH HAMILTON | 742800601 - (TX) DELL CHILDRENS MEDICAL GROUP | TX | Audiologist (231H00000X) |
United | 69436 | $186.91 | 1689601072 - WILLIAM SCOTT | 264210862 - (TX) GEOFFREY SCOTT MD PA | TX | Otolaryngology Physician (207Y00000X) |
United | 69436 | $432.57 | 1487730271 - MATTHEW RYAN | 756002868 | TX | Otolaryngology Physician (207Y00000X) |
United | 69436 | $145.08 | 1174036073 - DOUGLAS KING | 746000203 | TX | Physical Therapist (225100000X) |
United | 69436 | $137.42 | 1588200372 - ELDON CUMMINGS | 900120192 - (TX) SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO PA | TX | Physical Therapist (225100000X) |
United | 69436 | $169.75 | 1073631404 - WEST TEXAS ALLERGY, PA | 752781652 - (TX) WEST TEXAS ALLERGY PA | TX | Allergy & Immunology Physician (207K00000X) |
United | 69436 | $359.66 | 1184808511 - STACEY CLARK | 742800601 - (TX) DELL CHILDRENS MEDICAL GROUP | TX | Pediatric Otolaryngology Physician (207YP0228X) |
United | 69436 | $207.21 | 1316990336 - ENT SPECIALISTS OF ABILENE, LLP, EAR NOSE & THROAT SPECIALISTS | 752628398 - (TX) ENT SPECIALISTS OF ABILENE LLP | TX | Otolaryngology Physician (207Y00000X) |
United | 69436 | $169.25 | 1881696342 - DEVANG DESAI | 760522391 - (TX) TEXAS EAR NOSE THROAT SPECIALISTS PLLC | TX | Otolaryngology Physician (207Y00000X) |
United | 69436 | $121.26 | 1740282029 - MILES SYKES | 760467095 - (TX) SOUTHEAST TEXAS MEDICAL ASSOCIATES, LLP | TX | Physical Therapist (225100000X) |
United | 69436 | $194.02 | 1801358858 - PALMILA LIU | 752306021 - (TX) TEXAS EAR NOSE THROAT SPECIALISTS LLP | TX | Otolaryngology Physician (207Y00000X) |
United | 69436 | $229.25 | 1841383486 - KRISTA OLSON | 741613878 - (TX) BAYLOR COLLEGE OF MEDICINE | TX | Plastic Surgery within the Head & Neck (Otolaryngology) Physician (207YX0007X) |
United | 69436 | $190.92 | 1124766753 - ANDREA MATHIS | 620819926 - MSK GROUP, PC DBA ORTHOSOUTH | TX | Physical Therapist (225100000X) |
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 69436 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69436 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 69436 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 69436. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69436 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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