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 |
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 | $3510.00 | 1972911030 - SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC, THE SURGERY CENTER AT SOUTHEASTERN HEALTH PARK | 452413077 - (NC) SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $4785.00 | 1972565745 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE SURGERY CENTER AT RAINIER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $971.00 | 1225378276 - WHITE OAK SURGERY CENTER | 273885555 - (GA) WHITE OAK SURGERY CENTER | GA | 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 | 69637 | $5433.00 | 1700887643 - MNH SURGICAL CENTER INC, MNH SURGICAL CENTER | 263094275 | 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 | $2800.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $2318.00 | 1053934919 - DOYLESTOWN SURGERY CENTER, LLC | 834549561 - (PA) DOYLESTOWN SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $4785.00 | 1760421846 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE EVERETT BONE AND JOINT SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $3487.00 | 1023271459 - RIVERBEND AMBULATORY SURGERY CENTER LLC, DAY SURGERY AT RIVERBEND | 205575145 - (OR) RIVERBEND AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $3354.00 | 1841884731 - EYE MD OF NICEVILLE SURGERY LLC | 862163581 - (FL) EYE MD OF NICEVILLE SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $5340.00 | 1336852854 - BAPTIST BEACHES SURGERY CENTER LLC, HORIZON SURGERY CENTER BEACHES | 884322867 - (FL) BAPTIST BEACHES SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $5020.00 | 1932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE | 821568426 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $3320.00 | 1215900246 - SUNRISE OPHTHALMOLOGY ASC LLC, FOUNDATION FOR ADVANCED EYE CARE | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69637 | $2111.00 | 1013612423 - ARLINGTON HEIGHTS SURGERY CENTER, LLC | 301341813 - (IL) ARLINGTON HEIGHTS SURGERY CENTER LLC | IL | 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 | Moderate | Myringoplasty Uncomplicated |
| 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)) |
| 69636 | High | Tympanoplasty With Antrotomy Or Mastoidotomy (Including Canalplasty, Atticotomy, Middle Ear Surgery, And/Or Tympanic Membrane Repair); With Ossicular Chain Reconstruction |
| 69637 | 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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