CPT 69637 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 69637 |
National average reimbursement for CPT 69637 by major payers:
$1,925.93
$1,774.77
$1,891.23
$2,329.45
| 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 69637 | ||||||
United | 69637 | $971.00 | 1225378276 - WHITE OAK SURGERY CENTER | 273885555 - (GA) WHITE OAK SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $1339.00 | 1023005139 - ROANOKE VALLEY CENTER FOR SIGHT LLC | 541982898 - (VA) ROANOKE VALLEY CENTER FOR SIGHT LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $1150.00 | 1093726309 - INSIGHT SURGERY & LASER CENTER, LLC | 203458868 - (OH) INSIGHT SURGERY LASER CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $4488.00 | 1225531544 - ANNE ARUNDEL-SCA SURGICENTER, LLC | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $911.00 | 1023399318 - CANDESCENT EYE SURGICENTER LLC | 452898656 | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $1120.57 | 1588136774 - JULIE LANDESS | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 69637 | $4475.00 | 1730296997 - DAY SURGERY LIMITED LIABILITY | 550737750 - (WV) DAY SURGERY LLC | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $1168.00 | 1619284536 - CHILDRENS SURGERY CENTER, LLC | 273074039 - (PA) CHILDRENS SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $5354.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $5249.00 | 1891253035 - ADVANCED CENTER FOR SURGERY, THE ADVANCED CENTER FOR SURGERY | 611917634 - (FL) ADVANCED CENTER FOR SURGERY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $1617.00 | 1306320338 - ALABAMA EYE SURGERY CENTER LLC | 814662532 - (AL) ALABAMA EYE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $2965.00 | 1316536352 - UROLOGICAL INSTITUTE OF MARYLAND | 352636464 - (MD) UROLOGICAL INSTITUTE OF MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $5433.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $930.00 | 1992777643 - CAPE CORAL FT MYERS ENDOSCOPY ASC LLC, GULF COAST ENDOSCOPY CENTER SOUTH | 621767599 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $1167.00 | 1801457478 - DIALYSIS ACCESS CENTER, LLC | 834488032 - (OH) DIALYSIS ACCESS CENTER LLC | OH | 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 69637 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69637 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 69637 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-CPT | Moderate | Myringoplasty Uncomplicated |
| 69633-CPT | 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)) |
| 69636-CPT | High | Tympanoplasty With Antrotomy Or Mastoidotomy (Including Canalplasty, Atticotomy, Middle Ear Surgery, And/Or Tympanic Membrane Repair); With Ossicular Chain Reconstruction |
| 69637-CPT | High | Tympanoplasty With Antrotomy Or Mastoidotomy (Including Canalplasty Atticotomy Middle Ear Surgery And/Or Tympanic Membrane Repair); 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 69637. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69637 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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