CPT 69554 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 69554 by major payers:
$3,261.06
$3,249.12
$3,319.64
$4,175.36
| 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 69554 | ||||||
United | 69554 | $797.00 | 1174590434 - HARMONY SURGERY CENTER, LLC, HARMONY AMBULATORY SURGERY CENTER, LLC | 841479751 - (CO) HARMONY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $300.00 | 1700856242 - SOUTHERN OHIO EYE SURGERY CENTER, LLC | 43700734 - (OH) SOUTHERN OHIO EYE SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $630.00 | 1871538694 - SOUTHWEST ENDOSCOPY LTD | 850452091 - (NM) SOUTHWEST ENDOSCOPY LTD | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $3493.00 | 1073558912 - CHRISTUS SANTA ROSA SURGERY CENTER L.L.P., CHRISTUS SANTA ROSA SURGERY CENTER | 810571409 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $1028.00 | 1649223124 - CAMP LOWELL SURGERY CENTER,LLC, CAMP LOWELL SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $684.00 | 1902043284 - AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE | 911886576 - (WA) ELIE LEVY, M.D., P.C. DBA AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $535.00 | 1154554160 - CABRILLO SURGERY CENTER | 270666008 - (CA) CABRILLO SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $1607.00 | 1730466483 - HOAG OUTPATIENT CENTERS, LLC, HOAG ENDOSCOPY CENTER | 453587572 - (CA) HOAG OUTPATIENT CENTERS LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $491.00 | 1023056090 - GAILEY EYE SURGERY-DECATUR LLC | 364542211 - (IL) GAILEY EYE SURGERYDECATUR LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $354.00 | 1235112814 - MT PLEASANT SURGICAL CENTER, LLC, MT PLEASANT SURGICAL CENTER | 752691365 - (TX) MT PLEASANT SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $122.00 | 1699711556 - ESCNC LLC, EYE SURGERY CENTER OF NORTHERN CALIFORNIA | 462800751 - (CA) ESCNC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $600.00 | 1295906956 - THE ENT CENTER OF RHODE ISLAND LLC, THE SURGERY CENTER OF RHODE ISLAND | 260329297 - (RI) THE ENT CENTER OF RHODE ISLAND | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $2785.00 | 1083912745 - RED ROCKS SURGERY CENTERS, LLC | 271095323 - (CO) RED ROCKS SURGERY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $1049.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $750.00 | 1265959795 - BHATTI GI SURGERY CENTER LLC | 822151132 - (MN) BHATTI GI SURGERY CENTER LLC | MN | 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 69554 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69554 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 69554 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 |
|---|---|---|
| 69550-CPT | High | Exc Aural Glomus Tumor Transcanal |
| 69552-CPT | High | Excision Aural Glomus Tumor;Transmastoid |
| 69554-CPT | High | Exc Aural Glomus Tumor Extratempor |
| 69646-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Radical Or Complete, With Ossicular Chain Reconstruction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69554 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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