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 | $2575.00 | 1598729329 - SURGICARE OF ST ANDREWS LTD | 611276561 - (FL) SURGICARE OF ST ANDREWS LTD | FL | 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 | $500.00 | 1922178169 - IMPERIAL HEALTH, LLP | 721005645 - (LA) IMPERIAL HEALTH, LLP | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $920.00 | 1720129893 - PACIFIC GASTROENTEROLOGY ENDOSCOPY CENTER | 330898866 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $500.00 | 1164516084 - ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC | 113530475 - (NY) ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $2172.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $1793.00 | 1427044452 - THE SURGERY CENTER AT SELF MEMORIAL HOSPITAL, LLC, SURGERY CENTER OF THE LAKELANDS | 571087792 - (SC) THE SURGERY CENTER AT SELF MEM | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $63.00 | 1225286354 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $513.00 | 1992708929 - NOVAMED MANAGEMENT SERVICES LLC, ATLANTA EYE SURGERY CENTER | 364013255 - NOVAMED, INC. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $913.00 | 1912252693 - ROCKWOOD CLINIC PS, ROCKWOOD EYE SURGERY CENTER | 911352172 - MULTICARE HEALTH SYSTEM | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $2172.00 | 1992037352 - BAYLOR SURGICARE AT MANSFIELD, LLC, BAYLOR SCOTT & WHITE SURGICARE - MANSFIELD | 271835675 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $865.00 | 1386650778 - NORTH BEND MEDICAL CENTER INC, NBMC-DAY SURGERY | 371843700 | OR | 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 | $1306.00 | 1942267893 - GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, PA | 223345724 - (NJ) GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, P.A. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69554 | $426.00 | 1841226552 - NAPLES EYE SURGERY CENTER LLC | 20657002 - (FL) NAPLES EYE SURGERY CENTER LLC | FL | 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 | High | Exc Aural Glomus Tumor Transcanal |
| 69552 | High | Excision Aural Glomus Tumor;Transmastoid |
| 69554 | High | Exc Aural Glomus Tumor Extratempor |
| 69646 | 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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