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See a sample rate comparisonCPT 92700 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.
Unlisted Otorhinolaryngological Service Or Procedure
| 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 | GA - Required ABN issued and on file 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 92700 |
| Medicaid Fee Schedule | $17.34 median of the 3 states in the free preview · View Medicaid rates for 92700 |
National average reimbursement for CPT 92700 by major payers:
$633.16
$53.08
$20.00
$51.62
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CPT 92700
5 of 25 sample ratesHigher to lower in this preview
Winchester Medical Center
Valley Health System
$114.23Published rateLehigh Valley Hospital- Pocono, Pocono Medical Center
Pocono Medical Center
$94.76Published rateOneida Health Systems, Inc, Oneida Healthcare Center
Oneida Healthcare Systems Inc
$69.76Published rateEast Ohio Hospital LLC
$54.93Published rateWhite River Health System, Inc., White River Medical Center
White River Health System Inc
$29.94Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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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