CPT code 92502: ENT examination, under general anesthesia2026 Medicare rate & RVUs in Illinois
A broad ear, nose, and throat examination performed under general anesthesia when a complete diagnostic assessment cannot be completed while the patient is awake.
CMS doesn’t publish an office rate for 92502 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 92502 covers
92502 captures a broad otolaryngologic assessment performed while the patient is under general anesthesia, allowing the clinician to examine relevant ear, nasal, oral, pharyngeal, and laryngeal structures when an awake examination is inadequate or cannot be completed. Otolaryngologists commonly perform it in an operating room or procedure setting, often for young children or patients unable to cooperate with a complete awake exam.
Report 92502 for the examination itself, not simply because general anesthesia is used for another procedure. The record should explain why an awake examination was insufficient and document the findings or anatomic areas examined. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery payment are not allowed.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 92502 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $91.78 |
| East St. Louis, IL | Unavailable | $87.54 |
| Rest of Illinois | Unavailable | $85.64 |
| Suburban Chicago, IL | Unavailable | $90.60 |
How the 92502 rate is calculated
Each of 92502’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 92502
RVUs × geographic indexes × conversion factor
Work1.47
1.47 RVUs× 1.000 GPCI
Practice expense1.01
1.01 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
2.5900
Conversion factor
$33.4009
Medicare rate
$86.51
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92502
The CMS indicators that decide how 92502 is paid alongside other services.
CMS payment indicators · 92502
ENT examination, under general anesthesia
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
92502 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92504Ear microscopyBinocular diagnostic examination
- 92502 is a broad otolaryngologic examination under general anesthesia; 92504 is a separate diagnostic ear examination using binocular microscopy.
- 92511NasopharyngoscopyEndoscopic nasopharynx exam
- 92511 is a focused endoscopic examination of the nasopharynx, not a broad examination of the ear, nose, and throat under general anesthesia.
- 31575LaryngoscopyFlexible, diagnostic
- 31575 describes flexible diagnostic laryngoscopy focused on the larynx. Choose 92502 when the service is a broader otolaryngologic examination under general anesthesia.
92502 billing questions
When should 92502 be selected instead of 92504?
Use 92502 for a broad otolaryngologic examination performed under general anesthesia. Code 92504 describes examination of the ear using a binocular microscope.
Can 92502 be reported with a focused scope examination?
A focused nasopharyngoscopy or laryngoscopy is a distinct service from the broad examination represented by 92502. Report another procedure only when it was separately performed and the documentation supports it.
Is modifier 50 appropriate for examining both ears?
No. CMS identifies bilateral adjustment as inappropriate for 92502.
What same-day care is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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