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 |
National average reimbursement for CPT 69716 by major payers:
$783.17
$836.37
$788.61
$1,066.69
| 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 69716 | ||||||
United | 69716 | $906.00 | 1942808571 - SIGHT PARTNERS PHYSICIANS, P.C., THE HARMAN EYE CLINIC | 911719913 - SIGHT PARTNERS, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69716 | $1811.22 | 1912954744 - TERRY CORWIN | 320261234 | WA | Urology Physician (208800000X) |
United | 69716 | $1299.06 | 1568824217 - RAND WILCOX VANDEN BERG | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | WA | Urology Physician (208800000X) |
United | 69716 | $612.02 | 1760684732 - VAL IRION | 720715014 - MUSCULOSKELETAL INSTITUTE OF LOUISIANA | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $916.97 | 1306013925 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69716 | $1168.69 | 1467688069 - LISA WINTERROTH | 910564748 - SEATTLE CHILDRENS HOSPITAL | WA | Allergy & Immunology Physician (207K00000X) |
United | 69716 | $809.09 | 1548243199 - BRYAN SMITH | 721527724 - (WA) PALOUSE UROLOGY, PLLC | WA | Urology Physician (208800000X) |
United | 69716 | $1006.88 | 1316973811 - ANDREW VERNEUIL | 911009308 - (WA) BELLINGHAM EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, INC. P.S. | WA | Otolaryngology Physician (207Y00000X) |
United | 69716 | $564.53 | 1659464618 - RALPH JUNIUS | 273652036 - (LA) R.WILLIAM JUNIUS, III, M.D., L.L. C. DBA CRESCENT CITY ORTHOPEDICS | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $881.02 | 1356722938 - USA VASCULAR CENTERS OF KENT PLLC | 474051242 - (WA) USA VASCULAR CENTERS OF KENT PLLC | WA | Multi-Specialty Group (193200000X) |
United | 69716 | $683.23 | 1346451648 - ONER KHERA | 860934279 - (AZ) PHOENIX ORTHOPAEDIC CONSULTANTS, | LA | Orthopaedic Surgery Physician (207X00000X) |
United | 69716 | $3200.00 | 1881631497 - NEW IBERIA SURGERY CENTER LLC | 721455114 - (LA) NEW IBERIA SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69716 | $6365.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69716 | $809.09 | 1235575861 - PROFESSIONAL RECREATION ORGANIZATION, INC., PRO SPORTS CLUB | 911256440 - (WA) PROFESSIONAL RECREATION ORGANIZATION, INC. | WA | Multi-Specialty Group (193200000X) |
United | 69716 | $1485.15 | 1386674802 - DAVID SANTOS | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Otolaryngology Physician (207Y00000X) |
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 | High | Implant/Replace Elec. Bone Conduc.Hearin |
| 69714 | High | Implantation, Osseointegrated Implant, Temporal Bone, With Percutaneous Attachment To External Speech Processor/Cochlear Stimulator; Without Mastoidectomy |
| 69716 | Moderate | Implantation Osseointegrated Implant Skull; Withmagnetic 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 (Desc Rvsd 1/1/23) |
| 69717 | High | Replacement (Including Removal Of Existing Device) Osseointegrated Implant Skull; With Percutaneous Attachment To External Speech Processor (Desc Rvsd 1/1/23) |
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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