How much does Medicare pay for CPT 69930?

Medicare allowed an average of $4653.15 per service and paid $3702.94 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $14,206, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 69930?

Insertion of cochlear device. It was billed 3,356 times to 3,302 Medicare beneficiaries by 177 providers in 2024.

Does 69930 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1126.60 in an office setting and $4741.48 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 69930 most?

Otolaryngology, with 2,897 services from 156 clinicians. Next are Ambulatory Surgical Center, Physician Assistant.

CPT 69930

Insertion of cochlear device

$4653.15Medicare-allowed amount per service, averaged across 3,356 services

Providers submitted

$14,206

Asking price, not received

Medicare allowed

$4653.15

The fee schedule figure

Medicare paid

$3702.94

Balance is patient coinsurance

Providers submitted an average of $14,206 for this code and Medicare allowed $4653.15 — 3.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $3702.94 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1126.60
Hospital / facility: $4741.48

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 82 services were billed in an office setting and 3,274 in a facility.

Services: 3,356
Beneficiaries: 3,302
Providers billing it: 177
Total allowed: $15,615,971

What Medicare pays for CPT 69930

Across 3,356 services billed by 177 providers to 3,302 beneficiaries, Medicare allowed an average of $4653.15 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 69930

Specialty	Services	Beneficiaries	Avg allowed	Providers
Otolaryngology	2,897	2,856	$1178.45	156
Ambulatory Surgical Center	448	435	$27,233	20
Physician Assistant	11	11	$163.69	1

69930 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	319	$8198.24	$4998.69	17
Florida	262	$6200.19	$5332.53	12
Arizona	228	$6987.80	$5725.12	9
Texas	178	$7469.46	$6012.90	11
Tennessee	155	$2695.49	$2332.14	8
Alabama	146	$10,694	$9875.79	5
Kansas	131	$1095.96	$946.93	5
South Carolina	127	$1125.16	$944.65	6
Maryland	108	$6127.55	$4851.54	5
Colorado	104	$5292.50	$4207.51	5
Indiana	100	$7485.37	$6253.30	5
North Carolina	88	$4689.76	$3826.64	6
Iowa	87	$1076.96	$917.97	4
Minnesota	85	$1219.77	$954.36	4
Georgia	77	$1198.57	$931.41	4
Pennsylvania	76	$1255.36	$948.62	4
Washington	75	$8993.26	$6606.31	4
Massachusetts	63	$1312.15	$939.32	4
Arkansas	61	$7564.12	$6950.82	3
Virginia	61	$6588.91	$5458.75	4
Ohio	60	$1177.49	$943.83	4
Missouri	59	$1142.71	$945.50	4
Illinois	56	$1268.26	$961.70	4
Oklahoma	56	$1109.76	$958.45	3
Michigan	54	$1219.62	$943.84	3
Mississippi	48	$9088.31	$8016.36	3
Montana	47	$1179.55	$947.45	3
Wisconsin	42	$1134.04	$938.61	3
Louisiana	42	$1106.28	$930.04	2
Oregon	42	$1269.38	$951.84	2
Utah	41	$1160.03	$963.48	3
North Dakota	37	$1152.27	$940.68	2
New York	35	$1392.58	$945.63	3
Nebraska	34	$1011.71	$931.37	1
Kentucky	32	$1121.64	$914.30	2
Idaho	26	$1097.27	$949.06	2
New Hampshire	24	$1203.12	$939.17	2
West Virginia	19	$1078.25	$990.96	1
Alaska	18	$1483.77	$938.66	1
Nevada	16	$29,719	$22,158	1
New Mexico	13	$1232.03	$948.13	1
South Dakota	12	$1142.02	$941.65	1
Delaware	12	$1141.15	$911.78	1

Related codes

69990Use of operating microscope$204.48

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.