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CPT 69805 Fee Schedule

Last Verified: November 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.

Op Endolymphatic Sac Wo Shunt
Key FactDetail
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 LevelHigh

National average reimbursement for CPT 69805 by major payers:

bcbs

$1,426.36

uhc

$1,351.69

aetna

$1,392.72

cigna

$1,727.68

Preview provider-level rates for...
For billing codeCPT 69805
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 69805

United
69805$2251.001306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC510571797VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$2100.001891728382 - MISSISSIPPI COAST ENDOSCOPY & AMBULATORY CENTER LLC, MISSISSIPPI COAST ENDOSCOPY & AMBULATORY SURGICAL640927074 - (MS) MISSISSIPPI COAST ENDOSCOPY AND AMBULATORY CENTER, LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$5002.001396011615 - MEC ENDOSCOPY LLC900768532TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$876.001225077241 - CORTEZ FOOT SURGERY CENTER, P.A.650064196 - (FL) CORTEZ FOOT SURGERY CENTER PAFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$3103.001063999662 - SOUTHERN KENTUCKY SURGICENTER, LLC, GREENVIEW SURGERY CENTER474897131 - (KY) SOUTHERN KENTUCKY SURGICENTER LLCKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$2112.001245781459 - FRESENIUS VASCULAR CARE ST LOUIS ASC LLC, AZURA SURGERY CENTER ST. LOUIS814061712 - (MO) FRESENIUS VASCULAR CARE ST LOUIS ASC LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$5354.001053453134 - ADVANCED SURGICAL CONCEPTS LLC331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$5433.001093085904 - ARIZONA ADVANCED ENDOSCOPY LLC453051125 - (AZ) ARIZONA ADVANCED ENDOSCOPY, LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$4014.001154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE871712552 - (AZ) BSC 3 LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$1180.001295710317 - CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC203520333 - (FL) CENTRAL FLORIDA ENDOSCOPY SURGICAL INSTITUTE OF OCALA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$1471.001891724936 - ARKLAMISS SURGERY CENTER,LLC870741444 - (LA) ARKLAMISS SURGERY CENTERLLCLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$3612.001437155207 - TEXARKANA SURGERY CENTER LP752807190 - (TX) TEXARKANA SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$1442.001568674281 - VILLAGES ENDOSCOPY & SURGICAL CENTER LLC813250494FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$2776.001467833160 - AUSTELL SURGERY CENTER, LLC473077378 - (GA) AUSTELL SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
69805$4153.001023734084 - WEST GEORGIA SURGERY CENTER, LLC833671516 - (GA) TANNER MEDICAL CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 69805 vs. Other Surgical Procedures on the Auditory System Codes

The CPT 69805 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 69805 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.

CodeComplexityDescription
69805HighOp Endolymphatic Sac Wo Shunt
69806HighOp Endolymphatic Sac W Shunt
69905HighLabyrinthectomy Transcanal
69910HighLabyrinthectomy; With Mastoidectomy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 69805. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 69805 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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