CPT 69726 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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 69726 |
National average reimbursement for CPT 69726 by major payers:
$564.65
$573.69
$556.20
$760.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 69726 | $3570.00 | 1063092047 - TAMPA BAY JOINT AND SPINE, LLC, TAMPA BAY JOINT AND SPINE SURGERY CENTER | 851259146 - (FL) TAMPA BAY JOINT AND SPINE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $3623.00 | 1083624670 - PRESCOTT OUTPATIENT SURGICAL CENTER LLC | 860548048 - (AZ) PRESCOTT OUTPATIENT SURGICAL CENTER, LP | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $3100.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1275.00 | 1740251909 - NORTH FLORIDA GI CENTER LTD, HCA FLORIDA NORTH FLORIDA ENDOSCOPY CENTER | 621727350 - (FL) NORTH FLORIDA GI CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1397.00 | 1194712109 - EXECUTIVE ENDOSCOPY, INC, ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $600.00 | 1396812491 - VALLEY ENDOSCOPY CENTER, INC | 611435080 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $3623.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $2200.00 | 1538549852 - BAKERSFIELD SPECIALISTS SURGICAL CENTER, LLC | 465765998 - (CA) BAKERSFIELD SPECIALISTS SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1100.00 | 1649790171 - ATHENS SPINE PROCEDURAL CENTER LLC | 364870744 - (GA) ATHENS SPINE PROCEDURAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $2170.00 | 1932285111 - ORTHOVIRGINIA OPERATORY | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $6399.00 | 1336288703 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON ISSAQUAH ASC | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $2613.00 | 1518373695 - HOLLYWOOD SURGICAL CENTER, LLC | 462573171 - (FL) HOLLYWOOD SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $6290.00 | 1689832438 - INOVA WOODBURN SURGERY CENTER LLC | 540620889 - INOVA HEALTH CARE SERVICES | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $2369.00 | 1518300102 - SPRINGFIELD SURGERY CENTER, LLC | 461041413 - (NJ) SPRINGFIELD SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1300.00 | 1508840893 - PARKWAY SURGERY CENTER | 621799370 - (SC) PARKWAY SURGERY CENTER, LLC | 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 69726 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69726 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 69726 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 |
|---|---|---|
| 69644-CPT | High | Eardrum And Middle Ear Surgery, Surgery To Remove The Bone Behind The Ear (Mastoid Bone) And Reconstruct The Eardrum (Tympanic Membrane). The Procedure May Involve Reconstructing The Chain Of Middle Ear Bones That Transmit Sound (Ossicular Chain). |
| 69660-CPT | High | Surgery On The Middle Ear, Surgery On The Middle Ear To Remove One Of The Bones (Stapes Bone) And Replace It With A Prothesis (Man-Made) So That Sound Is Transmitted. |
| 69676-CPT | High | Neurectomy Tympanic Unilateral |
| 69726-CPT | Moderate | Removal Entire Oi Implt Skl Perq Attachment Esp, Removal Entire Osseointegrated Implant Skull; With Percutaneous Attachment To External Speech Processor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69726. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69726 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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