CPT 69645 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 69645 by major payers:
$1,890.36
$1,874.99
$2,005.57
$2,445.65
| 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 69645 | ||||||
United | 69645 | $3275.00 | 1568918746 - ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY, LLC | 812594417 - (FL) ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $3275.00 | 1639650161 - TRAILS EDGE SURGERY CENTER, LLC | 831528858 - (FL) TRAILS EDGE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $1948.00 | 1881658524 - CUMBERLAND VALLEY SURGERY CENTER, LLC | 753079478 - (MD) CUMBERLAND VALLEY SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $1374.00 | 1063466118 - VALLEY SURGICAL CENTER INC | 204211574 - (PA) VALLEY SURGICAL CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $805.00 | 1023015989 - TUCSON GASTROENTEROLOGY INSTITUTE, LLC | 860966257 - (AZ) TUCSON GASTROENTEROLOGY INSTITUTE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $3526.00 | 1710091517 - HERSHEY OUTPATIENT SURGERY CENTER LP, HERSHEY OUTPATIENT SURGERY CENTER | 200469951 - (PA) HERSHEY OUTPATIENT SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $1228.00 | 1548655053 - MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC | 463162562 - (MS) MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $10317.00 | 1376780916 - HAMILTON SURGERY CENTER LLC | 352061413 - (IN) HAMILTON SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $1000.00 | 1124091897 - PADUCAH OPHTHALMOLOGY ASC LLC, THE EYE SURGERY CENTER OF PADUCAH | 943428567 - (KY) PADUCAH OPHTHALMOLOGY ASC LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $5354.00 | 1811001860 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $3429.00 | 1629130521 - MIDWEST SURGERY CENTER, LLC, MIDWEST SURGERY CENTER- WOODBURY | 411537436 - (MN) MIDWEST SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $5433.00 | 1972092146 - SURGERY CENTRE OF SW FLORIDA LLC, FORT MYERS SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $2450.00 | 1144845116 - LEGACY CENTER FOR SPINAL SURGERY, LLC | 843166515 - (GA) LEGACY CENTER FOR SPINAL SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $6506.00 | 1427326677 - ENCINITAS ENDOSCOPY CENTER, LLC, THE ENDOSCOPY CENTER | 453608354 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69645 | $1550.00 | 1255604534 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC TUCSON | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | 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 69645 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69645 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 69645 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 |
|---|---|---|
| 69610-CPT | Moderate | Repair Tympanic Membrane Wo Graft |
| 69641-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Without Ossicular Chain Reconstruction |
| 69642-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); With Ossicular Chain Reconstruction |
| 69645-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Radical Or Complete, Without Ossicular Chain Reconstruction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69645. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69645 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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