CPT 69720 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 69720 by major payers:
$1,654.15
$1,532.91
$1,593.97
$1,977.56
| 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 69720 | ||||||
United | 69720 | $2131.00 | 1427015999 - WEST SHORE SURGERY, LTD, WEST SHORE SURGERY CENTER, LTD | 251821415 - (PA) WEST SHORE SURGERY CENTER, LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $2400.00 | 1699959387 - SAN DIEGO CA MULTI SPECIALTY ASC LLC, MISSION VALLEY HEIGHTS SURGERY CENTER | 261158246 - (CA) POWAY CA MULTI-SPECIALTY ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $6179.00 | 1316317134 - SUMMER STREET ASC LLC | 474990107 - (CT) SUMMER STREET ASC LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $4781.00 | 1548784556 - NORTH ATLANTIC SURGICAL SUITES, LLC | 821540859 - (NH) NORTH ATLANTIC SURGICAL SUITES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3792.00 | 1548322829 - GASTROINTESTINAL MEDICAL CENTER | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $1645.00 | 1225440969 - COPPEL SURGICAL SOLUTIONS, NEVADA SURGICAL SUITES | 460641933 - (NV) COPPEL SURGICAL SOLUTIONS | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3945.00 | 1881461705 - GLACIER SURGICAL CENTER, LLC | 861271667 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $7124.00 | 1730876210 - MEDICAL CITY SURGERY CENTER NORTH TEXAS, LLC | 923326615 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $2500.00 | 1902436348 - DLV VISION ASC | 842407060 - (CA) DLV VISION ASC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3177.00 | 1124492996 - MOHS AND SKIN SURGERY CENTER, LLC | 474284353 - (MD) MOHS AND SKIN SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $587.00 | 1790822864 - NORTHWEST EYE SPECIALISTS,LLC | 860720868 - (AZ) NORTHWEST EYE SPECIALISTS, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $5020.00 | 1720530405 - GRAND RAPIDS SURGICAL SUITES LLC | 811321919 - (MI) GRAND RAPIDS SURGICAL SUITES, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $1035.00 | 1518967082 - NOVAMED SURGERY CENTER OF OAK LAWN, LLC, CENTER FOR RECONSTRUCTIVE SURGERY OF OAK LAWN | 770618674 - (IL) NOVAMED SURGERY CENTER OF OAK LAWN LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3628.00 | 1891395661 - SPINE SOLUTIONS OF SHEBOYGAN LLC | 853646323 - (WI) SPINE SOLUTIONS OF SHEBOYGAN LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $7733.00 | 1275596264 - CAROLINA REGIONAL SURGERY CENTER. LTD | 621616402 - (SC) CAROLINA REGIONAL SURGERY CENTER LTD | SC | 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 69720 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69720 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 69720 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 |
|---|---|---|
| 69436 | Moderate | Tympanostomy Gen Anes |
| 69645 | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Radical Or Complete, Without Ossicular Chain Reconstruction |
| 69676 | High | Neurectomy Tympanic Unilateral |
| 69720 | High | Decompress.Facial Nrv,Intratemp;Lat.-Gen |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69720 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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