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See a sample rate comparisonCPT 69642 Fee Schedule
Last Verified: October 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.
Eardrum And Middle Ear Surgery, Surgery To Remove The Bone Behind The Ear (Mastoid Bone) And Reconstruct The Eardrum (Tympanic Membrane). The Procedure May Involve Reconstructing The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain).
| 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 69642 |
| Medicaid Fee Schedule | View Medicaid rates for 69642 |
National average reimbursement for CPT 69642 by major payers:
$1,878.35
$1,727.71
$1,827.73
$2,185.31
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CPT 69642
5 of 25 sample ratesHigher to lower in this preview
Providence Surgery Centers LLC, Creekside Surgical Center
Providence Surgery Centers LLC Dba Creekside Surgery Center
$6,763.00Published rateOcean Endosurgery Center LLC, Ocean Endosurgery Center
Ocean Endosurgery Center LLC
$4,703.00Published rateBlue Ridge Day Surgery Center, Lp, Blue Ridge Day Surgery Center
Blue Ridge Day Surgery Center Lp
$2,917.00Published rateDel Val Asc LLC, The Eye Surgery Center
Del Val Asc LLC
$1,700.00Published rateElkins Asc LLC, Gila Valley Procedure Center
Elkins Asc LLC
$713.00Published rate
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See a sample payer proposalCPT 69642 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69642 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 69642 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 |
|---|---|---|
| 69641-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Remove The Bone Behind The Ear (Mastoid Bone) And Reconstruct The Eardrum (Tympanic Membrane). The Procedure May Involve Reconstructing The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). |
| 69642-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Remove The Bone Behind The Ear (Mastoid Bone) And Reconstruct The Eardrum (Tympanic Membrane). The Procedure May Involve Reconstructing The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). |
| 69643-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Remove The Bone Behind The Ear (Mastoid Bone) And Reconstruct The Eardrum (Tympanic Membrane). The Procedure May Involve Reconstructing The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). |
| 69644-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Remove The Bone Behind The Ear (Mastoid Bone) And Reconstruct The Eardrum (Tympanic Membrane). The Procedure May Involve Reconstructing The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69642. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69642 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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