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CPT 69604 Fee Schedule

Last Verified: January 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.

Rev Mastoidect To Tympanoplasty
Key FactDetail
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

LT - Left side of body

RT - Right side of body

Complexity LevelHigh

National average reimbursement for CPT 69604 by major payers:

bcbs

$1,485.78

uhc

$1,438.62

aetna

$1,482.15

cigna

$1,858.05

Preview provider-level rates for...
For billing codeCPT 69604
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 69604

United
69604$2427.001740681733 - SURGCENTER OF GREATER PHOENIX, LLC465683789 - (AZ) SURGCENTER OF GREATER PHOENIX LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$1823.001811345267 - CAROLINAS AMBULATORY SURGERY INC., ATRIUM HEALTH SURGERY CENTER ROCK HILL812714217 - (SC) CAROLINAS AMBULATORY SURGERY INCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$1650.001225096134 - GAINESVILLE EYE CENTER, LLC201895224 - (GA) GAINESVILLE EYE CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$1400.001962050492 - PRECISION AMBULATORY SURGERY CENTER, LLC830978495 - (TX) PRECISION AMBULATORY SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$5966.001558487009 - MIDWEST DIGESTIVE HEALTH CENTER LLC431918703 - (MO) MIDWEST DIGESTIVE HEALTH CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$3275.001568918746 - ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY, LLC812594417 - (FL) ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$1680.001831636752 - RIVER VIEW SURGERY CENTER, LLC814790945 - (ID) RIVER VIEW SURGERY CENTER, LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$3151.001124093588 - UROLOGY SURGERY CENTER OF SAVANNAH, LLLP, UROLOGY SURGERY CENTER, LLP582511751 - (GA) UROLOGY SURGERY CENTER OF SAVANNAH LLLPGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$5249.001043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$5433.001366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY384016302FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$425.001578558078 - KINGSPORT ENDOSCOPY CORPORATION61249637 - (TN) KINGSPORT ENDOSCOPY CORPORATIONTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$4247.001477089126 - BISMARCK SINUS CENTER821303553 - (ND) BISMARCK SINUS CENTERNDAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$2087.001770581829 - PHYSICIANS' SURGERY CENTER, LLC481217506 - (KS) PHYSICIANS SURGERY CENTER, L.L.C.KSAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$5433.001811385883 - CENTRAL DELAWARE ENDOSCOPY UNIT LLC471840129DEAmbulatory Surgical Clinic/Center (261QA1903X)
United
69604$5433.001861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLCFLAmbulatory 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 69604 vs. Other Surgical Procedures on the Auditory System Codes

The CPT 69604 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 69604 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
69601-CPTHighRevis.Mastoidectomy;Results:Compl Mastoi
69604-CPTHighRev Mastoidect To Tympanoplasty

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 69604 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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