CPT 69805 Fee Schedule
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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 69805 by major payers:

$1,426.36

$1,351.69

$1,392.72

$1,727.68
| 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 69805 | ||||||
United | 69805 | $2251.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $2100.00 | 1891728382 - MISSISSIPPI COAST ENDOSCOPY & AMBULATORY CENTER LLC, MISSISSIPPI COAST ENDOSCOPY & AMBULATORY SURGICAL | 640927074 - (MS) MISSISSIPPI COAST ENDOSCOPY AND AMBULATORY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $5002.00 | 1396011615 - MEC ENDOSCOPY LLC | 900768532 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $876.00 | 1225077241 - CORTEZ FOOT SURGERY CENTER, P.A. | 650064196 - (FL) CORTEZ FOOT SURGERY CENTER PA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $3103.00 | 1063999662 - SOUTHERN KENTUCKY SURGICENTER, LLC, GREENVIEW SURGERY CENTER | 474897131 - (KY) SOUTHERN KENTUCKY SURGICENTER LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $2112.00 | 1245781459 - FRESENIUS VASCULAR CARE ST LOUIS ASC LLC, AZURA SURGERY CENTER ST. LOUIS | 814061712 - (MO) FRESENIUS VASCULAR CARE ST LOUIS ASC LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $5354.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $5433.00 | 1093085904 - ARIZONA ADVANCED ENDOSCOPY LLC | 453051125 - (AZ) ARIZONA ADVANCED ENDOSCOPY, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $4014.00 | 1154088490 - BSC 3 LLC, BANNER SURGERY CENTER - SPORTS MEDICINE | 871712552 - (AZ) BSC 3 LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $1180.00 | 1295710317 - CENTRAL FLORIDA ENDOSCOPY & SURGICAL INSTITUTE OF OCALA LLC | 203520333 - (FL) CENTRAL FLORIDA ENDOSCOPY SURGICAL INSTITUTE OF OCALA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $1471.00 | 1891724936 - ARKLAMISS SURGERY CENTER,LLC | 870741444 - (LA) ARKLAMISS SURGERY CENTERLLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $3612.00 | 1437155207 - TEXARKANA SURGERY CENTER LP | 752807190 - (TX) TEXARKANA SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $1442.00 | 1568674281 - VILLAGES ENDOSCOPY & SURGICAL CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $2776.00 | 1467833160 - AUSTELL SURGERY CENTER, LLC | 473077378 - (GA) AUSTELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69805 | $4153.00 | 1023734084 - WEST GEORGIA SURGERY CENTER, LLC | 833671516 - (GA) TANNER MEDICAL CENTER | GA | 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 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.
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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