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CPT 69540 Fee Schedule

Last Verified: January 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.

Excision Aural Polyp
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Auditory System

Common Place of Service

11 - Office

22 - On Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelModerate

National average reimbursement for CPT 69540 by major payers:

bcbs

$260.83

uhc

$261.85

aetna

$270.99

cigna

$345.54

Preview provider-level rates for...
For billing codeCPT 69540
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 69540

United
69540$800.001508531641 - ALLIANCE SURGERY CENTER AT SANDY SPRINGS LLC871977629 - (GA) ALLIANCE SURGERY CENTER AT SANDY SPRINGS LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$500.001871941468 - AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLC812463581 - (MD) AMBULATORY SURGERY CENTER FOR PELVIC NEURO SCIENCE LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$600.001619517539 - MOUNTAIN WEST DERM813253496WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$500.001265816003 - CLEARVIEW SURGERY CENTER, LLC474123527 - (ID) CLEARVIEW SURGERY CENTER LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$750.001073757480 - ENDOSCOPY CENTER OF WESTERN COLORADO INC262645683COAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$489.001528000817 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER860423068 - SOUTHWESTERN EYE CENTER, LTD.AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$1171.001649317660 - ORTHOVIRGINIA, INC540885859 - (VA) ORTHOVIRGINIA, INC.VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$745.001043690126 - BELLINGHAM UROLOGY GROUP, PLLC472435308WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$615.001376852855 - PAIN MANAGEMENT PROFESSIONALS OF BAYTOWN PLLC, ADVANCED PAIN MANAGEMENT SPECIALISTS OF BAYTOWN263216787 - PAIN MANAGEMENT PROFESSIONALS OF BAYTOWN PLLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$703.001396738936 - WARREN GASTRO ENDOSCOPY CTR INC341850936 - (OH) WARREN GASTRO ENDOSCOPY CTR INCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$401.001699813774 - LAUREL LASER & SURGERY CENTER, L.P., LAUREL LASER & SURGERY CENTER-ALTOONA251852464 - (PA) LAUREL LASER SURGERY CENTER LPPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$452.001639142656 - GREENSBORO OPHTHALMOLOGY ASC LLC, SURGICAL EYE CENTER621842511 - (NC) GREENSBORO OPHTHALMOLOGY LLC, ASCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$765.001437501145 - NORTH CARE ASC, LLC810851059 - (CO) NORTH CARE ASC LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
69540$165.381205465580 - KRISTEN BROWNING350593390 - DEACONESS HOSPITAL INCKYPhysician Assistant (363A00000X)
United
69540$445.001447231287 - GASTROENTEROLOGY SPECIALISTS INC, ENDOSCOPY CENTER341773267 - (OH) GASTROENTEROLOGY SPECIALISTS, INC.OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 69540 vs. Other Surgical Procedures on the Auditory System Codes

The CPT 69540 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 69540 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.

CodeComplexityDescription
69540-CPTModerateExcision Aural Polyp
69550-CPTHighExc Aural Glomus Tumor Transcanal
69552-CPTHighExcision Aural Glomus Tumor;Transmastoid
69601-CPTHighRevis.Mastoidectomy;Results:Compl Mastoi

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 69540 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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