CPT 69646 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 69646 by major payers:
$2,138.67
$1,992.13
$2,138.82
$2,597.61
| 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 69646 | ||||||
United | 69646 | $4764.00 | 1275886319 - SURGERY CENTER OF BAY AREA HOUSTON, LLC | 320383244 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $1679.00 | 1255472841 - LYNN EYE SURGERY CENTER, LLC, LYNN EYE SURGERY CENTER | 770048452 - (CA) LYNN EYE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $3722.00 | 1609537992 - NCH BONITA AMBULATORY SURGERY CENTER, LLC | 873854125 - (FL) NCH BONITA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $550.00 | 1265434740 - SALLY K BALIN AMBULATORY SURGICAL CENTER INC | 232969046 - (PA) SALLY K BALIN AMBULATORY SURGICAL CENTER INC. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $5354.00 | 1649515354 - SURGCENTER NORTHEAST LLC | 455554995 - (FL) SURGCENTER NORTHEAST, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $5433.00 | 1770929044 - SURGCENTER OF PALM BEACH GARDENS, SURGCENTER OF PALM BEACH GARDENS, LLC | 462315994 - (FL) SURGCENTER OF PALM BEACH GARDENS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $1500.00 | 1164495198 - SARASOTA OPHTHALMOLOGY ASC LLC, CENTER FOR ADVANCED EYE SURGERY | 621825704 - (FL) SARASOTA OPHTHALMOLOGY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $900.00 | 1326215468 - ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC | 261470972 - (MI) ST CLAIR SHORES MI OPHTHALMOLOGY ASC LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $3690.00 | 1922028265 - ATLANTIC GASTRO SURGICENTER, LLC, T/A ACCESS | 223645443 - (NJ) ATLANTIC GASTRO SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $2496.00 | 1225745870 - APOLLO SURGICAL CENTER LLC | 922033557 - (AZ) APOLLO SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $1425.00 | 1841284742 - KLEINERT KUTZ SURGERY CENTER, LLC | 352095662 - (IN) KLEINERT KUTZ SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $3160.00 | 1235466863 - AESTHETIC ASSOCIATES INC., P.S, SEATTLE FACIAL PLASTIC SURGERY CENTER | 911650765 - (WA) AESTHETIC ASSOCIATES INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $7012.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $5400.00 | 1760440515 - SIERRA ENDOSCOPY CENTER, LLC | 680482297 - (CA) SIERRA ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69646 | $4704.00 | 1093383655 - SHERMAN ENDOSCOPY CENTER, LLC | 861402910 - (TX) SHERMAN ENDOSCOPY CENTER LLC | 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 69646 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69646 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 69646 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 |
|---|---|---|
| 69631-CPT | High | Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear Surgery), Initial Or Revision; Without Ossicular Chain Reconstruction |
| 69632-CPT | High | Tympanoplasty Without Mastoidectomy (Including Canalplasty, Atticotomy And/Or Middle Ear Surgery), Initial Or Revision; With Ossicular Chain Reconstruction (Eg, Postfenestration) |
| 69641-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Without Ossicular Chain Reconstruction |
| 69646-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Radical Or Complete, With 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 69646. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69646 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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