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N669 Remark Code: Priced on Medicare Fee Schedule

N669 means the payer based its allowed amount on the Medicare fee schedule. Many commercial, workers' compensation, and auto payers price claims as a percentage of Medicare, so this remark shows up well beyond Medicare itself.

Quick facts

Code
N669 (RARC N669)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The difference between your charge and the Medicare-based allowed amount is a contractual or fee schedule write-off.
  • PR (Patient Responsibility): Patient cost-sharing based on the Medicare-derived allowed amount is reported under PR.
Official description
Adjusted based on the Medicare fee schedule.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N669 means

Medicare publishes detailed fee schedules for physician services, labs, equipment, and more, with rates adjusted by locality and setting. Because they’re public and updated regularly, other payers often borrow them. A commercial contract may pay a set percentage of Medicare, and many states’ workers’ compensation and auto no-fault rules do the same.

N669 tells you the allowed amount was derived from that Medicare schedule. By itself, it’s an explanation, not a problem.

Checking the amount

To confirm the payment, you need four things:

  • The Medicare rate for the code on the date of service, from the correct schedule year.
  • The locality, based on where the service was performed or the provider’s location under the payer’s rules.
  • The setting. Physician services have different facility and non-facility rates, driven by place of service in box 24B.
  • The multiplier in your contract or state rule, such as a percentage above or below Medicare.

Apply modifiers such as bilateral, assistant, or multiple procedure adjustments the same way Medicare would, unless your contract says otherwise.

When to follow up

  • The payer used an older year’s rates for a newer date of service.
  • The facility rate was applied to an office service, or the reverse, because of a place of service mismatch.
  • The wrong locality was used.
  • The contract percentage doesn’t match what was applied.

What to do

  1. Recalculate the expected amount from the correct Medicare rate and your multiplier.
  2. Post the adjustment if it matches.
  3. Correct the claim with resubmission code 7 if your place of service or location data caused the difference.
  4. Request reprocessing with your calculation if the payer applied the wrong rate, year, or percentage.

Codes that may appear with N669

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeded the allowed amount derived from the Medicare fee schedule.
  • N608 (The fee schedule amount allowed is calculated at 110% of the Medicare Fee Schedule for this region, specialty and type of service.): A specific version: the fee schedule amount is a set percentage of Medicare for the region and provider type.
  • N655 (Payment based on provider's geographic region.): Pricing based on the provider's geographic region.
  • N442 (Payment based on an alternate fee schedule.): Payment based on an alternate fee schedule.
  • N670 (This service code has been identified as the primary procedure code subject to the Medicare Multiple Procedure Payment Reduction (MPPR) rule.): The Medicare multiple procedure payment reduction applied to the primary procedure.

N669 FAQ

Why would a non-Medicare payer use the Medicare fee schedule?

It is a widely published benchmark. Many contracts and several state workers' compensation and auto systems set payment as a percentage of the Medicare amount.

Which Medicare rate should apply?

The one for the date of service, locality, and setting, such as facility or non-facility, adjusted by any percentage in your contract or the state rule.

What if the service has no Medicare rate?

Your contract or the state schedule usually has a fallback method, such as a percentage of charges or another schedule. The payer should not reduce it to zero just because Medicare has no amount.