CPT 69730 Fee Schedule
Last Updated: August 2025
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 | • 24 - Ambulatory Surgical Center • 22 - On Campus-Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • SG - From: Scene | To: Hospital-based ESRD Facility • 22 - Increased Procedural Services (surgical/procedures codes only) • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 69730 by major payers:
$1,053.78
$958.61
$878.40
$1,205.09
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Related Codes
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69730. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69730 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.
CPT 69730 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69730 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 69730 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.
| CPT Code | Complexity Level | Description |
|---|---|---|
| 69610 | Moderate | Repair Tympanic Membrane Wo Graft |
| 69714 | High | Implantation, Osseointegrated Implant, Temporal Bone, With Percutaneous Attachment To External Speech Processor/Cochlear Stimulator; Without Mastoidectomy |
| 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) |
| 69730 | High | Replacement (Including Removal Of Existing Device), 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 |
See what providers are getting paid in 2025 for 69730:
CPT 69730 Fee Schedule & Reimbursement Rates
The CPT 69730 fee schedule varies by payer type. Below are Medicare rates for 2025 and average in-network rates by state across major payers:
| Code | Medicare Rate | Avg. BCBS National Rate | More Info |
|---|---|---|---|
| 69610 | $385.47 | $497.36 | |
| 69714 | $496.98 | $1,028.92 | |
| 69719 | $645.78 | $712.06 | |
| 69725 | $1,869.43 | $2,530.99 | |
| 69729 | $674.41 | $993.05 | |
| 69730 | $699.37 | $1,053.78 |
Reimbursement rates depend on provider contracts, region, and payer. Always verify rates with your insurance provider or medical billing department.
What is Price Transparency?
The Price Transparency Rule is a federal law that took effect in July 2022, requiring all commercial payers to publicly disclose their prices through machine-readable files (MRFs). This landmark regulation mandates that insurance companies make healthcare costs transparent to the public.
Our data comes directly from these insurer-posted MRFs, ensuring compliance with the Price Transparency Rule. While PayerPrice is working toward a future where providers and payers collaborate for 100% upfront price certainty, it's important to acknowledge that data limitations and occasional errors may exist.
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