CPT 92700 Fee Schedule
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.
| 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 | • None • GA - Required ABN issued and on file • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 92700 by major payers:

$633.16

$53.08

$20.00

$50.74
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 92700 | ||||||
United | 92700 | $147.24 | 1205889458 - PRISMA HEALTH-MIDLANDS, PRISMA HEALTH BAPTIST HOSPITAL | 582296052 - (SC) PRISMA HEALTH-MIDLANDS | SC | General Acute Care Hospital (282N00000X) |
United | 92700 | $29.94 | 1710943881 - WHITE RIVER HEALTH SYSTEM, INC., WHITE RIVER MEDICAL CENTER | 710411459 - WHITE RIVER HEALTH SYSTEM INC | AR | General Acute Care Hospital (282N00000X) |
United | 92700 | $51.29 | 1275350050 - BMC COMMUNITY HOSPITAL CORPORATION | 994491180 | MA | Radiation Oncology Clinic/Center (261QX0203X) |
United | 92700 | $111.80 | 1144775032 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OP SURGERY PATEWOOD | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92700 | $34.22 | 1083903744 - HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUIS, ST. BERNARD PARISH HOSPITAL | 261576974 - (LA) HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST BERNARD STATE OF LOUIS | LA | Rural Acute Care Hospital (282NR1301X) |
United | 92700 | $72.05 | 1699726695 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 92700 | $71.41 | 1285295899 - AHN EMERUS WESTMORELAND LLC, AHN MCCANDLESS NEIGHBORHOOD HOSPITAL | 823697883 - (PA) AHN EMERUS WESTMORELAND LLC | PA | General Acute Care Hospital (282N00000X) |
United | 92700 | $42.84 | 1922201268 - MILLCREEK COMMUNITY HOSPITAL | 251002937 - (PA) MILLCREEK COMMUNITY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | 92700 | $119.22 | 1124574223 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH PATEWOOD HOSPITAL | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92700 | $59.06 | 1275608457 - RIDGEVIEW MEDICAL CENTER | 311667875 - RIDGEVIEW MEDICAL CENTER | MN | General Acute Care Hospital (282N00000X) |
United | 92700 | $126.70 | 1508835828 - THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO | 911352172 - MULTICARE HEALTH SYSTEM | OH | General Acute Care Hospital (282N00000X) |
United | 92700 | $60.43 | 1942204490 - JAMES D. TATE, M.D., PATIENTS HOSPITAL OF REDDING | 942677467 - (CA) JAMES D TATE MD | CA | General Acute Care Hospital (282N00000X) |
United | 92700 | $111.80 | 1659827756 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-GROVE | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92700 | $111.80 | 1265988364 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CARDIOVASCULAR SVCS SIMP | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 92700 | $75.50 | 1851332431 - TUFTS MEDICAL CENTER | 43400617 - TUFTS MEDICAL CENTER PARENT INC | MA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 92700 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92700 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 92700 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 |
|---|---|---|
| 92700-CPT | Moderate | Unlisted Otorhinolaryngological Service Or Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92700. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92700 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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