CPT 69631 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 | • 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 |
National average reimbursement for CPT 69631 by major payers:
$1,229.80
$1,135.78
$1,258.21
$1,482.06
| 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 69631 | ||||||
United | 69631 | $2040.00 | 1841858735 - ELITE AMBULATORY SURGERY CENTER, LLC | 841973218 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $9421.00 | 1649931072 - MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS, LLC, MEDICAL CITY ORTHOPEDIC & SPINE SURGERY CENTER DALLAS | 842824507 - (TX) MEDICAL CITY SPECIALTY SURGICENTER OF DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $1700.00 | 1093760019 - OCEAN COUNTY EYE ASSOCIATES LLC, OCEAN COUNTY EYE SURGERY CENTER | 223256927 - (NJ) OCEAN COUNTY EYE ASSOCIATES, P.C. | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $953.00 | 1871718270 - PRINCE GEORGES MULTI SPECIALTY SURGERY CENTER | 521842302 - (MD) PRINCE GEORGES MULTI SPECIALTY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $6506.00 | 1396211264 - PALM BEACH SURGICAL SUITES LLC | 830558319 - (FL) PALM BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $699.00 | 1528307188 - SGFC SURGERY CENTER, LLC, SGFC SURGERY CENTER | 208131466 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $7225.00 | 1144612714 - ANCHORAGE SURGICENTER, LLC | 472881055 | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $2600.00 | 1174634778 - THE CENTER FOR SPECIALIZED SURGERY, LP | 203364256 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $2429.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $1690.00 | 1437113206 - ORLANDO SURGICARE LTD | 752375604 - (FL) ORLANDO SURGICARE LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $1669.00 | 1154986347 - CENTER FOR VISUAL SURGICAL EXCELLENCE, LLC | 820674025 - (VA) CENTER FOR VISUAL SURGICAL EXCELLENCE LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $3427.00 | 1679696157 - ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES, LLC, SLOCUM AMBULATORY SURGERY CENTER | 770590285 - (OR) ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $895.00 | 1841270675 - EYECARE CONSULTANTS SURGERY CENTER, LLC, EYECARE CONSULTANTS SURGERY CENTER | 621619550 - (IN) EYECARE CONSULTANTS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $1901.00 | 1689216152 - BAPTIST HEALTH SURGERY CENTER LLC | 843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, L | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69631 | $7124.00 | 1104947357 - TARRANT COUNTY SURGERY CENTER LP | 710985084 - (TX) TARRANT COUNTY SURGERY CENTER LP | TX | 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 69631 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69631 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 69631 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 |
|---|---|---|
| 69620 | Moderate | Myringoplasty Uncomplicated |
| 69631 | High | Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear Surgery), Initial Or Revision; Without Ossicular Chain Reconstruction |
| 69632 | High | Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear Surgery), Initial Or Revision; With Ossicular Chain Reconstruction (Eg, Postfenestration) |
| 69633 | High | Tympanoplasty Without Mastoidectomy (Including Canalplasty Atticotomy And/Or Middle Ear Surgery) Initial Or Revision; With Ossicular Chain Reconstruction And Synthetic Prosthesis (Eg Partial Ossicular Replacement Prosthesis (Porp) Total Ossicular Replacement Prosthesis (Torp)) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69631. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69631 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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