CPT 69905 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 69905 by major payers:

$1,278.92

$1,182.90

$1,211.67

$1,534.32
| 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 69905 | ||||||
United | 69905 | $3424.00 | 1265401202 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S., THE ORTHOPAEDIC SURGERY CENTER | 911502837 - NORTHWEST ORTHOPAEDIC SPECIALISTS, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $3200.00 | 1063750867 - MENLO PARK SURGERY CENTER, LLC. | 263669436 - (NJ) MENLO PARK SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $4500.00 | 1861804585 - DENVILLE SURGERY CENTER, LLC, SURGICAL CENTER OF NORTHWEST JERSEY | 352507803 - (NJ) DENVILLE SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $6903.00 | 1164776266 - UNIVERSITY OF KANSAS HOSPITAL | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $5966.00 | 1275545279 - SURGERY CENTER OF COLUMBIA LP | 205227138 - (MO) SURGERY CENTER OF COLUMBIA LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $6000.00 | 1790721769 - SAN FRANCISCO SURGERY CENTER, LP | 870689493 - (CA) SAN FRANCISCO SURGERY CENTER, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $4575.00 | 1750303855 - MEADOWS SURGERY CENTER, LLC, MEADOWS SURGERY CENTER | 200181381 - (NJ) MEADOWS SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $3506.00 | 1508500273 - GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC | 262157335 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $5354.00 | 1396174454 - SURGERY CENTER OF SCOTTSDALE LLC | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $1427.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $1858.00 | 1518264332 - SANTA FE SURGERY CENTER LLC | 272869086 - (FL) SANTA FE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $8076.00 | 1528521887 - NOVANT HEALTH CLEMMONS OUTPATIENT SURGERY, LLC | 825250651 - (NC) NOVANT HEALTH CLEMMONS OUTPATIENT SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $2749.00 | 1043690126 - BELLINGHAM UROLOGY GROUP, PLLC | 472435308 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $5820.00 | 1649655515 - PARKWAY SURGERY CENTER, LLC, PARKWAY SURGERY CENTER AT HORIZON RIDGE | 880403777 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 69905 | $1737.00 | 1922180439 - DL-JT MANAGEMENT SERVICES, LLC, CENTENNIAL SURGERY CENTER, LLC | 880499721 - CENTENNIAL SPINE & PAIN CENTER | NV | 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 69905 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69905 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 69905 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 69905. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69905 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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