CPT 69728 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 69728 by major payers:
$873.86
$827.03
$752.33
$1,043.11
| 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 69728 | ||||||
United | 69728 | $4339.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $2699.00 | 1972805299 - ST. VINCENT'S OUTPATIENT SURGERY SERVICES LLC | 200708162 - (AL) ST VINCENTS OUTPATIENT SURGERY SERVICES LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $3188.00 | 1003861998 - PHYSICIANS SURGERY CENTER OF CHATTANOOGA, LLC, PHYSICIANS SURGERY CENTER OF CHATTANOOGA | 621817952 - (TN) PHYSICIANS SURGERY CENTER OF CHATTANOOGA LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1288.00 | 1932204971 - GREENVILLE ENDOSCOPY CENTER INC | 570965754 - (SC) GREENVILLE ENDOSCOPY CENTER INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $4600.00 | 1750347472 - BAYLOR SURGICARE AT NORTH DALLAS, LLC, BAYLOR SCOTT & WHITE SURGICARE-NORTH DALLAS | 752900902 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $5798.00 | 1144275629 - FOUNDATION SURGERY AFFILIATE OF FORT WAYNE, LLC, PARKVIEW SOUTHWEST SURGERY CENTER | 201394120 - (IN) FOUNDATION SURGERY AFFILIATES OF FW INVERNESS SURGERY CENTER | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1050.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $2277.00 | 1326469172 - EHI SURGERY CENTER AUSTIN, LLC | 464266877 - (TX) EHI SURGERY CENTER AUSTIN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1500.00 | 1215410592 - ALLIANCE SURGERY CENTER AT WOODSTOCK, LLC | 830957221 - (GA) ALLIANCE SURGERY CENTER AT WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $3623.00 | 1992992994 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1242.00 | 1134677990 - CENTER FOR EYE SURGERY, LLC | 813369249 - (FL) CENTER FOR EYE SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1335.00 | 1679706790 - DIGESTIVE DISEASE CENTER-GREEN VALLEY | 880291959 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1713.00 | 1710163670 - PHYSICIAN SURGERY CENTER AT ANMED HEALTH LLC | 570359174 - ANMED HEALTH | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $2609.00 | 1235155730 - MONTPELIER SURGERY CENTER | 770548811 - (CA) MONTPELIER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $3570.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | 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 69728 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69728 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 69728 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 |
|---|---|---|
| 69620-CPT | Moderate | Myringoplasty Uncomplicated |
| 69676-CPT | High | Neurectomy Tympanic Unilateral |
| 69719-CPT | Moderate | Replacement (Including Removal Of Existing Device) Osseointegrated Implant Skull; With Magnetic Transcutaneous Attachment To External Speech Processor Within The Mastoid And/Or Involving A Bony Defect Less Than 100 Sq Mm Surface Area Of Bone Deep To The Outer Cranial Cortex (Desc Rvsd 1/1/23) |
| 69728-CPT | Moderate | Removal, Entire Osseointegrated Implant, Skull; With Magnetic Transcutaneous Attachment To External Speech Processor, Outside The Mastoid And Involving A Bony Defect Greater Than Or Equal To 100 Sq Mm Surface Area Of Bone Deep To The Outer Cranial Cortex |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69728. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69728 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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