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 | $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 | $5249.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | 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 | $3722.00 | 1609537992 - NCH BONITA AMBULATORY SURGERY CENTER, LLC | 873854125 - (FL) NCH BONITA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $2448.00 | 1851678981 - RIDGECREST SPECIALTY SURGERY CENTER, A PROFESSIONAL CORPORATION | 453602999 - (CA) RIDGECREST SPECIALTY SURGERY CENTER A PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $2913.00 | 1477831360 - GEORGIA OPHTHALMOLOGISTS LLC, GEORGIA OPHTHALMOLOGISTS AMBULATORY SURGERY CENTER | 452069323 - (GA) GEORGIA OPHTHALMOLOGISTS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $1550.00 | 1356383640 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $1979.00 | 1922027176 - SAN DIEGO EYECOR LLC | 330636700 - (CA) SAN DIEGO EYE COR., INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $5020.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3300.00 | 1326555491 - GI NORTH ENDOSCOPY.LLC | 822774947 - (GA) GI NORTH ENDOSCOPYLLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3265.00 | 1306375837 - CENTRAL COAST CARDIOVASCULAR ASC LLC | 821736669 - (CA) CENTRAL COAST CARDIOVASCULAR ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $4000.00 | 1013104389 - TRACY SURGERY CENTER, LLC, TRACY SURGERY CENTER, LLC | 203762687 - (CA) TRACY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $5249.00 | 1790252864 - TREASURE COAST ASC, LLC, TREASURE COAST CENTER FOR SURGERY | 384092821 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $3956.00 | 1538736459 - PONY CREEK ANNEX, LLC | 844833158 - (OR) PONY CREEK ANNEX LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69720 | $2933.00 | 1528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC | 201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLC | KS | 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-CPT | Moderate | Tympanostomy Gen Anes |
| 69645-CPT | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Radical Or Complete, Without Ossicular Chain Reconstruction |
| 69676-CPT | High | Neurectomy Tympanic Unilateral |
| 69720-CPT | 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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