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 | $895.00 | 1871847319 - WISCONSIN LASER AND SURGERY CENTER LLC | 461222222 | WI | 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 | $1035.00 | 1720161771 - EYE CARE SURGERY CENTER OF OLIVE BRANCH,LLC | 470920340 | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1144.00 | 1306938550 - WEST GEORGIA ENDOSCOPY CENTER | 753182533 - (GA) WEST GEORGIA ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $3570.00 | 1750823886 - LAKE ENDOSCOPY CENTER, LLC | 814225104 - (FL) LAKE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $6342.00 | 1902850506 - TEXAS HEALTH SURGERY CENTER PRESTON PLAZA, LLC, TEXAS HEALTH SURGERY CENTER PRESTON PLAZA | 203991622 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $3570.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1335.00 | 1679706790 - DIGESTIVE DISEASE CENTER-GREEN VALLEY | 880291959 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $2792.00 | 1053565259 - SOUTHWEST LINCOLN SURGERY CENTER, LLC, SOUTHWEST LINCOLN SURGERY CENTER | 262981972 - (NE) SOUTHWEST LINCOLN SURGERY CENTER LLC | NE | 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 | $1288.00 | 1932204971 - GREENVILLE ENDOSCOPY CENTER INC | 570965754 - (SC) GREENVILLE ENDOSCOPY CENTER INC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $3214.00 | 1619576824 - SURGICARE OF LA VETA, LTD., NEWPORT COAST SURGICAL INSTITUTE | 752507129 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $1635.00 | 1447385158 - HARBIN CLINIC, LLC, HARBIN GI | 582234927 - (GA) THE HARBIN CLINIC, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $2434.00 | 1538122569 - CENTENNIAL SURGERY CENTER LP | 621624530 - (TN) CENTENNIAL SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69728 | $2937.00 | 1962506618 - THE POLYCLINIC, ASC POLYCLINIC SURGERY CENTER | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | 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 | Moderate | Myringoplasty Uncomplicated |
| 69676 | High | Neurectomy Tympanic Unilateral |
| 69719 | 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 | 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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