# CPT 69990: Microsurgical techniques requiring use of operating microscope (add-on)

Medicare CPT 69990 pays $198.07 in a non-facility setting and $198.07 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $164.30 in Wisconsin to $242.15 in Florida, a 47% spread.

Web page: https://www.med-reveal.com/rates/69990-cpt-fee-schedule
Section: Surgery and Procedures

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $198.07 |
| National facility | $198.07 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Florida | $242.15 | $242.15 |
| Illinois | $239.44 | $239.44 |
| Alaska | $236.04 | $236.04 |
| New York | $224.61 | $224.61 |
| District of Columbia | $216.35 | $216.35 |
| Michigan | $214.61 | $214.61 |
| Connecticut | $213.08 | $213.08 |
| West Virginia | $212.96 | $212.96 |
| New Jersey | $212.62 | $212.62 |
| Georgia | $205.56 | $205.56 |
| Maryland | $204.79 | $204.79 |
| New Mexico | $204.16 | $204.16 |
| Pennsylvania | $201.49 | $201.49 |
| Massachusetts | $198.83 | $198.83 |
| Montana | $197.97 | $197.97 |
| Puerto Rico | $197.80 | $197.80 |
| Virgin Islands | $197.80 | $197.80 |
| Washington | $197.29 | $197.29 |
| Louisiana | $196.85 | $196.85 |
| Rhode Island | $196.48 | $196.48 |
| Ohio | $195.04 | $195.04 |
| Texas | $194.78 | $194.78 |
| Missouri | $194.12 | $194.12 |
| New Hampshire | $193.87 | $193.87 |
| Delaware | $193.47 | $193.47 |
| Colorado | $191.75 | $191.75 |
| Utah | $190.99 | $190.99 |
| Nevada | $190.35 | $190.35 |
| Arizona | $190.17 | $190.17 |
| Kentucky | $189.78 | $189.78 |
| Oregon | $188.22 | $188.22 |
| South Carolina | $188.13 | $188.13 |
| California | $188.01 | $188.01 |
| Wyoming | $186.00 | $186.00 |
| Hawaii | $183.88 | $183.88 |
| Virginia | $183.75 | $183.75 |
| Oklahoma | $183.53 | $183.53 |
| Mississippi | $180.52 | $180.52 |
| Maine | $178.99 | $178.99 |
| North Carolina | $178.69 | $178.69 |
| Vermont | $174.74 | $174.74 |
| Alabama | $173.03 | $173.03 |
| Tennessee | $173.02 | $173.02 |
| Indiana | $171.35 | $171.35 |
| Kansas | $171.29 | $171.29 |
| North Dakota | $170.49 | $170.49 |
| Idaho | $170.47 | $170.47 |
| Arkansas | $170.04 | $170.04 |
| South Dakota | $167.24 | $167.24 |
| Iowa | $166.75 | $166.75 |
| Minnesota | $166.52 | $166.52 |
| Nebraska | $166.18 | $166.18 |
| Wisconsin | $164.30 | $164.30 |

## Related codes

- 31535: Laryngoscopy, direct, with biopsy — https://www.med-reveal.com/rates/31535-cpt-fee-schedule
- 31570: Laryngoscopy with injection into vocal cord(s) — https://www.med-reveal.com/rates/31570-cpt-fee-schedule
- 31575: Laryngoscopy, flexible, diagnostic — https://www.med-reveal.com/rates/31575-cpt-fee-schedule
- 31578: Laryngoscopy with removal of foreign body — https://www.med-reveal.com/rates/31578-cpt-fee-schedule
- 31590: Laryngeal reinnervation — https://www.med-reveal.com/rates/31590-cpt-fee-schedule
- 42410: Excision of parotid tumor or parotid gland, lateral lobe, without nerve dissection — https://www.med-reveal.com/rates/42410-cpt-fee-schedule
- 42420: Excision of parotid gland, total, with dissection of facial nerve — https://www.med-reveal.com/rates/42420-cpt-fee-schedule
- 42440: Excision of submandibular gland — https://www.med-reveal.com/rates/42440-cpt-fee-schedule

Commercial negotiated rates for 69990 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules