CPT 69930 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 69930 by major payers:
$1,622.06
$1,597.64
$1,767.27
$2,078.91
| 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 69930 | ||||||
United | 69930 | $1629.78 | 1467688069 - LISA WINTERROTH | 910946924 - (WA) NORTHWEST ASTHMA & ALLERGY CENTER | WA | Allergy & Immunology Physician (207K00000X) |
United | 69930 | $2076.30 | 1043702186 - JEFFREY FALCO | 911072626 - (WA) SPOKANE VALLEY EAR, NOSE & THROAT, P.S. | WA | Otolaryngology Physician (207Y00000X) |
United | 69930 | $3137.91 | 1689612954 - SWEDISH HEALTH SERVICES | 911911869 | WA | Multi-Specialty Group (193200000X) |
United | 69930 | $1702.73 | 1376949248 - DHIRENDRA MD PLLC | 472241173 - (WA) DHIRENDRA MD PLLC DBA-GMCP | WA | Multi-Specialty Group (193200000X) |
United | 69930 | $3125.61 | 1629031752 - WILLIAM ANDERSON | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | Allergy & Immunology Physician (207K00000X) |
United | 69930 | $3369.52 | 1396987863 - LISLY CHERY | 760273984 | WA | Urology Physician (208800000X) |
United | 69930 | $6375.77 | 1528396231 - ANOBEL ODISHO | 943281660 | WA | Urology Physician (208800000X) |
United | 69930 | $1780.72 | 1861629636 - CHAD RUFFIN | 352030653 - ARNETT CLINIC LLC | WA | Otolaryngology Physician (207Y00000X) |
United | 69930 | $1702.73 | 1518560184 - MAX VISION PLLC, EYE 5 OPTICAL | 853708172 - (WA) MAX VISION PLLC | WA | Multi-Specialty Group (193200000X) |
United | 69930 | $57603.00 | 1598196206 - EBD BEMC BURLESON, LLC, BAYLOR EMERGENCY MEDICAL CENTER AT MANSFIELD | 364755936 | TX | General Acute Care Hospital (282N00000X) |
United | 69930 | $2579.13 | 1881645638 - ALBERT MERATI | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | WA | Otolaryngology Physician (207Y00000X) |
United | 69930 | $1652.01 | 1578927398 - MATTHEW PEREZ | 910946924 - (WA) NORTHWEST ASTHMA & ALLERGY CENTER | VA | Allergy & Immunology Physician (207K00000X) |
United | 69930 | $1702.73 | 1417603739 - J E PARALES MEDICAL PLLC | 874390993 - (WA) J E PARALES MEDICAL PLLC | WA | Multi-Specialty Group (193200000X) |
United | 69930 | $2809.20 | 1861629636 - CHAD RUFFIN | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Otolaryngology Physician (207Y00000X) |
United | 69930 | $1700.64 | 1518407758 - RN BREASTFEEDING SUPPORT LLC, PACIFIC WELLNESS & LACTATION | 810944793 - (WA) RN BREASTFEEDING SUPPORT LLC | WA | Multi-Specialty Group (193200000X) |
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 69930 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69930 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 69930 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 69930. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69930 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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