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See a sample rate comparisonCPT 69950 Fee Schedule
Last Verified: October 2026
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.
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| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Auditory System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body 62 - Co-Surgeons 51 - Multiple procedures 78 - Return to OR - related procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 69950 |
| Medicaid Fee Schedule | View Medicaid rates for 69950 |
National average reimbursement for CPT 69950 by major payers:
$2,327.93
$2,313.78
$2,334.19
$2,926.60
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CPT 69950
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Southwest LLP, Memorial Hermann Surgery Center Southwest
Memorial Hermann Surgery Center Southwest LLP
$5,554.00Published rateSummit Ambulatory Surgical Center, LLC
$1,028.00Published ratePacific Gastro Health PLLC, Pacific Gastro Health
Pacific Gastroenterology, PLLC
$650.00Published rateRoanoke Valley Center For Sight LLC
$477.00Published rateHazleton Ambulatory Surgical Center LLC
$200.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 69950 vs. Other Surgical Procedures on the Auditory System Codes
The CPT 69950 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 69950 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 69950. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 69950 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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