CPT 69801 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 69801 by major payers:
$412.77
$423.40
$372.05
$483.10
| 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 69801 | ||||||
United | 69801 | $981.00 | 1558782268 - HOUSTON SURGERY CENTER | 464007273 - (TX) HOUSTON SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $728.00 | 1093716037 - CATARACT AND REFRACTIVE SURGERY CENTER, LLC, NOVAMED SURGERY CENTER OF RICHMOND, LLC | 621865972 - (VA) CATARACT AND REFRACTIVE SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $1390.00 | 1700888658 - WESTON OUTPATIENT SURGICAL CENTER LTD, WESTON OUTPATIENT SURGICAL CENTER | 650930629 - (FL) WESTON OUTPATIENT SURGICAL CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $1200.00 | 1265931653 - HEALTHCARE ENTERPRISES LLC, THE SURGERY CENTER | 471428524 - (MA) HEALTHCARE ENTERPRISES LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $624.00 | 1659548329 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $1258.00 | 1245529189 - CAPITOL SURGICAL CENTER LLC | 275067646 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $2701.00 | 1164870895 - SUMMIT ORTHOPEDICS LTD, EAGAN SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $864.00 | 1184316432 - PRISMA HEALTH AMBULATORY SURGERY CENTERS-MIDLANDS, LLC | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $1528.00 | 1992796742 - SAN ANTONIO ENDOSCOPY, LP, SAN ANTONIO ENDOSCOPY CENTER | 202511329 - (TX) SAN ANTONIO ENDOSCOPY LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $736.00 | 1679585772 - MEDICAL CENTER ENDOSCOPY, LLC, MEDICAL CENTER ENDOSCOPY | 760550704 - (TX) MEDICAL CENTER ENDOSCOPY, LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $295.00 | 1215967351 - FRIENDSHIP AMBULATORY SURGERY CENTER, FRIENDSHIP AMBULATORY SURGERY CENTER | 521873474 - (MD) FRIENDSHIP AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $528.00 | 1245340603 - MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER | 30408358 - (TN) MOUNTAIN EMPIRE CATARACT EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $856.00 | 1083653554 - UROLOGY SURGICAL PARTNERS, LLC | 582622573 - (GA) UROLOGY SURGICAL PARTNERS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $2392.00 | 1285976183 - TEXAS HEALTH FLOWER MOUND ORTHOPEDIC SURGERY CENTER LLC | 800866449 - (TX) TEXAS HEALTH FLOWER MOUND ORTHOPEDIC SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69801 | $1233.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | 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 69801 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69801 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 69801 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69801. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69801 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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