How much does Medicare pay for CPT 69990?

Medicare allowed an average of $204.48 per service and paid $163.41 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1346.94, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 69990?

Use of operating microscope. It was billed 4,094 times to 4,007 Medicare beneficiaries by 230 providers in 2024.

Which specialty bills 69990 most?

Neurosurgery, with 3,830 services from 213 clinicians. Next are Physician Assistant, Nurse Practitioner, Neurology.

CPT 69990

Use of operating microscope

$204.48Medicare-allowed amount per service, averaged across 4,094 services

Providers submitted

$1346.94

Asking price, not received

Medicare allowed

$204.48

The fee schedule figure

Medicare paid

$163.41

Balance is patient coinsurance

Providers submitted an average of $1346.94 for this code and Medicare allowed $204.48 — 6.6× 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 $163.41 (80%); the rest is the patient’s coinsurance and deductible.

Services: 4,094
Beneficiaries: 4,007
Providers billing it: 230
Total allowed: $837,141

What Medicare pays for CPT 69990

Across 4,094 services billed by 230 providers to 4,007 beneficiaries, Medicare allowed an average of $204.48 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 69990

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	3,830	3,748	$214.34	213
Physician Assistant	125	123	$28.31	7
Nurse Practitioner	88	88	$26.69	6
Neurology	27	25	$192.86	2
Orthopedic Surgery	12	11	$221.97	1
Pediatric Medicine	12	12	$206.65	1

69990 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	665	$206.12	$162.07	34
Texas	367	$210.79	$161.86	19
Arizona	279	$190.31	$160.86	11
Florida	272	$227.28	$155.68	15
New York	228	$257.56	$168.91	14
Pennsylvania	222	$209.57	$161.18	13
Massachusetts	173	$223.13	$169.69	8
Washington	171	$173.02	$135.67	12
Illinois	140	$252.22	$167.44	8
Tennessee	120	$161.51	$157.87	8
North Carolina	109	$185.05	$169.88	5
Wisconsin	104	$196.48	$169.64	5
South Carolina	99	$190.20	$167.64	7
Indiana	86	$122.83	$106.90	4
Maryland	85	$233.69	$170.03	5
Minnesota	83	$186.75	$169.96	6
Ohio	79	$197.70	$161.58	6
Kentucky	77	$199.51	$169.65	5
Virginia	75	$207.49	$170.16	5
Colorado	66	$203.51	$169.82	4
Oregon	62	$209.98	$167.22	4
Arkansas	51	$178.38	$171.22	2
Louisiana	44	$202.65	$169.84	3
Connecticut	43	$225.72	$167.35	3
New Jersey	40	$229.30	$169.32	2
Michigan	40	$250.18	$169.95	2
Kansas	40	$193.68	$169.67	2
Idaho	36	$104.04	$96.22	2
Vermont	33	$194.79	$165.47	2
North Dakota	28	$113.81	$100.80	2
South Dakota	27	$113.89	$104.37	2
New Hampshire	24	$201.11	$171.21	1
Alabama	22	$189.96	$169.65	2
Oklahoma	16	$198.66	$169.63	1
Utah	16	$209.28	$169.47	1
Rhode Island	15	$211.36	$169.97	1
Delaware	15	$227.03	$169.97	1
Missouri	15	$223.42	$169.78	1
Maine	14	$171.66	$162.40	1
Iowa	13	$183.47	$169.73	1

Related codes

69930Insertion of cochlear device$4653.15

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.