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See a sample rate comparisonCPT 69511 Fee Schedule
Last Verified: October 2026
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.
Remove Bones In And Near Ear, Surgery To Remove The Mastoid Bone (Bone Behind The Ear) As Well As All Of The Bones Of The Middle Ear.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Auditory System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 69511 |
| Medicaid Fee Schedule | View Medicaid rates for 69511 |
National average reimbursement for CPT 69511 by major payers:
$1,595.13
$1,589.37
$1,663.66
$2,037.10
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CPT 69511
5 of 25 sample ratesHigher to lower in this preview
Texas Health Craig Ranch Surgery Center LLC
$8,238.00Published rateMain Line Spine Surgery Center, LLC
Main Line Spine Surgery Center LLC
$3,690.00Published rateGeorgia Lithotripsy And Laser Center
$1,988.00Published rateFresno Endoscopy Center
$1,523.50Published rateSgfc Surgery Center, LLC, Sgfc Surgery Center
$699.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 69511 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69511 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 69511 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 |
|---|---|---|
| 69436-CPT | Moderate | Procedure To Place Ear Tubes, A Procedure To Implant Tubes Into The Ears In Order To Balance Eardrum Pressure Or Treat Frequent Ear Infections. |
| 69440-CPT | Moderate | Middle Ear Explora Through Postauricular Or Ear Canal Ncision, Middle Ear Exploration Through Postauricular Or Ear Canal Incision |
| 69505-CPT | High | Remove Bones In And Near Ear, Surgery To Remove The Mastoid Bone (Bone Behind The Ear) As Well As Some Of The Bones Of The Middle Ear. |
| 69511-CPT | High | Remove Bones In And Near Ear, Surgery To Remove The Mastoid Bone (Bone Behind The Ear) As Well As All Of The Bones Of The Middle Ear. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69511. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69511 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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