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 |
National average reimbursement for CPT 69726 by major payers:
$564.65
$573.69
$556.20
$780.86
| 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 69726 | ||||||
United | 69726 | $2599.00 | 1093771073 - ARTEL LLC | 263513966 - (CA) ARTEL, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $4140.00 | 1043708019 - OAK POINT SURGICAL SUITES LLC | 823437812 - (TX) OAK POINT SURGICAL SUITES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1879.00 | 1609103399 - TOURNEY PLAZA SURGICAL CENTER | 262034187 - (CA) TOURNEY PLAZA SURGICAL CENTER | CA | 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 | $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 | $1175.00 | 1629107545 - LANIER EYE ASSOCIATES, LLC, ADVANCED EYE SURGERY AND LASER CENTER | 50559435 - (GA) LANIER EYE ASSOCIATES LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1980.00 | 1982978466 - NORTHWEST ENT SURGERY CENTER, LLC | 453307193 - (GA) NORTHWEST ENT SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $4890.00 | 1861538613 - CENTRACARE SURGERY CENTER, LLC | 611514974 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $2010.00 | 1316991938 - SURGICAL AND DIAGNOSTIC CENTER, L.P. | 752874229 - (TX) SURGICAL AND DIAGNOSTIC CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1175.00 | 1932298718 - OUTPATIENT SERVICES EAST | 630888861 - (AL) OUTPATIENT SERVICES EAST LTD | AL | 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 | $8541.08 | 1144348194 - ALLE-KISKI MEDICAL CENTER | 251875178 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $2010.00 | 1366809055 - DFW CHILDRENS SURGERY CENTER LLC | 475442947 - (TX) DFW CHILDRENS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $4633.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69726 | $1226.00 | 1073030532 - AKDHC SURGERY CENTER, LLC | 753052504 | AZ | 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 | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); With Intact Or Reconstructed Canal Wall, With Ossicular Chain Reconstruction |
| 69660 | High | Stapedectomy Restor Ossic Continuit |
| 69676 | High | Neurectomy Tympanic Unilateral |
| 69726 | Moderate | Removal Entire Osseointegrated Implant Skull; With Percutaneous Attachment To External Speech Proccessor (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 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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