CPT 69716 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 69716 |
National average reimbursement for CPT 69716 by major payers:
$783.17
$836.37
$788.61
$1,042.73
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 69716 | $653.96 | 1336309129 - JOSEPH FINSTEIN | 463936183 - (LA) LMG, LLC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $899.00 | 1114943123 - WILLIAM DEAN | 273473897 - (WA) NORTHWEST PHYSICIANS MEDICAL GROUP, LLC | WA | Urology Physician (208800000X) |
United | 69716 | $1167.97 | 1871106187 - AMY BROOKMAN | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Allergy & Immunology Physician (207K00000X) |
United | 69716 | $809.09 | 1548243199 - BRYAN SMITH | 721527724 - (WA) PALOUSE UROLOGY, PLLC | WA | Urology Physician (208800000X) |
United | 69716 | $1080.25 | 1548230048 - PETER VIZZI | 263025784 - (LA) LOUISIANA ORTHOPAEDIC SPECIALISTS, LLC | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $797.57 | 1710973839 - SANJEEV JAIN | 342046854 - (CA) COLUMBIA ASTHMA & ALLERGY CLIN | WA | Allergy & Immunology Physician (207K00000X) |
United | 69716 | $1341.55 | 1134531494 - TYLER SWISS | 542183221 | WA | Otolaryngology Physician (207Y00000X) |
United | 69716 | $16368.00 | 1023418035 - ST. FRANCIS HOSPITAL INC, ST. FRANCIS CANCER CENTER | 582504530 - (SC) ST FRANCIS HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 69716 | $18055.00 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 69716 | $1485.15 | 1386674802 - DAVID SANTOS | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Otolaryngology Physician (207Y00000X) |
United | 69716 | $2078.84 | 1326088014 - JEFFREY EVANS | 912073120 | WA | Urology Physician (208800000X) |
United | 69716 | $1299.06 | 1568824217 - RAND WILCOX VANDEN BERG | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | WA | Urology Physician (208800000X) |
United | 69716 | $766.21 | 1821049743 - DAVID ELIAS | 260458213 - (LA) ORTHOPAEDIC SPORTS SPECIALISTS | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $836.51 | 1902801962 - RANDOLPH TAYLOR | 201607327 | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $1443.25 | 1861768582 - ANGELIQUE BERENS | 910214500 - THE EVERETT CLINIC, PLLC | WA | Otolaryngology/Facial Plastic Surgery Physician (207YX0905X) |
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 69716 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69716 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 69716 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 |
|---|---|---|
| 69710-CPT | High | Implnt Or Replac Of Electromagnetic Bone Conduct Hearing, Implantation Or Replacement Of Electromagnetic Bone Conduction Hearing |
| 69714-CPT | High | Implantation Osseointegrated I, Implantation Osseointegrated Implant Temporal Bonew Percutaneous Attachment To External Speech Processorcochlear Stimulator Without Mastiodectomy |
| 69716-CPT | Moderate | Impl Oi Implt Sk Tc Esp 100, Implantation Osseointegrated Implant Skull With Magnetic Transcutaneous Attachment To External Speech Processor Within The Mastoid And Or Resulting In Removal Of Less Than 100 Sq Mm Surface Area Of Bone Deep To The Outer Cranial Cortex |
| 69717-CPT | High | Replace Implanted Hearing Aid, Surgery To Remove An Existing Hearing Aid And Replace It With A New One Implanted Into The Bone. The Device Has An External Processor. The Procedure May Include Modifying The Bone Behind The Ear (Mastoid Bone). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69716. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69716 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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