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See a sample rate comparisonCPT 92511 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Nasopharyngoscopy With Endoscope
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 58 - Staged or related procedure during postoperative period |
| Complexity Level | Low |
| Medicare Fee Schedule | $115.90 national non-facility rate (2026) · View Medicare rates for 92511 |
| Medicaid Fee Schedule | $93.54 median of the 8 states in the free preview · View Medicaid rates for 92511 |
National average reimbursement for CPT 92511 by major payers:
$152.75
$160.01
$178.40
$84.50
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CPT 92511
5 of 25 sample ratesHigher to lower in this preview
Srishti Nangia
$344.48Published rateRhonda Lampen
Multicare Health System
$86.59Published rateAwesense Rehab Corp
$55.00Published rateDecker Therapy Services, LLC
Decker Therapy Services LLC
$40.00Published rateCynthia Stephens
Gc Therapy Lake City Inc
$35.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92511 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92511 code is part of the Medicine Services and Procedures services used for Special Otorhinolaryngologic Services and Procedures. 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 92511 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.
| Code | Complexity | Description |
|---|---|---|
| 92502-CPT | Low | Otolaryngologic Exam - Gen.Anesth |
| 92504-CPT | Low | Binocular Microscopy |
| 92507-CPT | Low | Treatment Of Speech Language, Treatment Of Speech Language Voice Communication And Orauditory Processing Disorder (Includes Aural Rehabilitation) Individual |
| 92511-CPT | Low | Nasopharyngoscopy With Endoscope |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92511. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92511 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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