CPT 69799 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 69799 by major payers:
$966.26
$131.92
$1,419.23
$497.01
| 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 69799 | ||||||
United | 69799 | $75.00 | 1972214682 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $81.00 | 1023343720 - HATTIESBURG SURGERY CENTER, LLC | 263789784 - (MS) HATTIESBURG SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $230.00 | 1437615929 - BANNER ENTICARE TEMPE SURGERY CENTER LLC, BANNER TEMPE SURGERY CENTER | 833567835 - (AZ) BANNER ENTICARE TEMPE SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $761.00 | 1558053868 - LORAIN AMHERST SURGERY CENTER LLC | 853470191 - (OH) LORAIN AMHERST SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $566.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $652.53 | 1619096161 - THE WESTERN PENNSYLVANIA HOSPITAL, FORBES REGIONAL CAMPUS | 250969492 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $150.00 | 1144370594 - THIRD STREET SURGERY CENTER LLC, THIRD STREET SURGERY CENTER LP | 841663840 - (CA) THIRD STREET SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $574.00 | 1942715826 - SAFETY HARBOR ASC COMPANY LLC, SAFETY HARBOR SURGERY CENTER | 320547161 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $500.00 | 1275629081 - VISION CARE OF MAINE LLC | 10525143 - (ME) VISION CARE OF MAINE LLC | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $1708.00 | 1447320213 - FREEHOLD ENDOSCOPY ASSOCIATES, LLC, ENDOSCOPY CENTER OF MONMOUTH COUNTY | 841634126 - (NJ) FREEHOLD ENDOSCOPY ASSOCIATES | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $100.00 | 1740228790 - CAPITAL SURGERY CENTER LLC | 522325983 - (MD) CAPITAL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $91.00 | 1588644520 - WESTGLEN ENDOSCOPY CENTER LLC, WESTGLEN ENDOSCOPY CENTER | 621707329 - WESTGLEN ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $566.00 | 1841712452 - SAINT THOMAS SURGERY CENTER NEW SALEM, LLC | 822137177 - (TN) SAINT THOMAS SURGERY CENTER NEW SALEM LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $681.00 | 1164012142 - COMPREHENSIVE DIGESTIVE SURGICENTER, LLC, COMPREHENSIVE DIGESTIVE SURGICAL CENTER | 854015524 - (NV) COMPREHENSIVE DIGESTIVE SURGICENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69799 | $100.00 | 1952404550 - WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC | 650789191 - (FL) WEST PALM BEACH CHILDRENS SURGERY CENTER LLC | FL | 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 69799 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69799 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 69799 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 |
|---|---|---|
| 69636 | High | Tympanoplasty With Antrotomy Or Mastoidotomy (Including Canalplasty, Atticotomy, Middle Ear Surgery, And/Or Tympanic Membrane Repair); With Ossicular Chain Reconstruction |
| 69641 | High | Tympanoplasty With Mastoidectomy (Including Canalplasty, Middle Ear Surgery, Tympanic Membrane Repair); Without Ossicular Chain Reconstruction |
| 69676 | High | Neurectomy Tympanic Unilateral |
| 69799 | Moderate | Unlisted Procedure,Middle Ear |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69799. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69799 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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