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CPT code 92511: Nasopharyngoscopy, endoscopic nasopharynx exam2026 Medicare rate & RVUs in Washington, DC area

Reports endoscopic visualization of the nasopharynx, commonly used by an ENT clinician to evaluate obstruction, adenoid tissue, or a suspected lesion.

CMS RVU26DEffective Oct 1, 2026One payment locality33.9K Medicare services in 2024

In Washington, DC area, Medicare pays $134.00 for 92511 in the office and $36.03 when it’s performed in a hospital or facility.

$134.00Office (non-facility)
$36.03Hospital or facility
+15.6%vs the national office rate ($115.90)

Check a contract rate as a % of Medicare · 92511 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 92511 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 92511 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 92511 covers

An ENT clinician typically passes a flexible or rigid endoscope through a nostril to examine the posterior nasal space and nasopharynx, including the area around the eustachian tube openings. Common reasons include persistent nasal obstruction, suspected adenoid enlargement, a visible or suspected nasopharyngeal lesion, or evaluation of unilateral middle-ear effusion. The service may be performed in an office or facility setting.

Report 92511 when the documented examination visualizes the nasopharynx; an examination limited to the nasal cavity or directed at the larynx represents a different service. The record should identify the indication, endoscopic approach, structures examined, and findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

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.

How Washington, DC area compares for 92511

Across 109 of 109 payment localities, the office rate for 92511 runs from $101.88 in Arkansas to $159.38 in San Benito County, CA. Washington, DC area pays $134.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

92511 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$134.00
  2. Los Angeles, CA · California$133.62−$0.38
  3. Miami, FL · Florida$121.83−$12.17
  4. Chicago, IL · Illinois$118.24−$15.76
  5. Manhattan, NY · New York$133.31−$0.69
  6. Alaska · Alaska$131.32−$2.68
  7. Alabama · Alabama$103.46−$30.54

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

92511 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$101.88$30.44
ArizonaArizona$112.77$32.18
Bakersfield, CACalifornia$124.86$33.71
Chico, CACalifornia$124.72$33.57
El Centro, CACalifornia$124.73$33.58
Fresno, CACalifornia$124.72$33.57
Hanford, CACalifornia$124.72$33.57
Madera, CACalifornia$124.72$33.57

92511 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$101.88

$142.05

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92511 office rate range by state
State / territoryOffice rate rangeLocalities
AK$131.321
AL$103.461
AR$101.881
AZ$112.771
CA$124.72–$159.3829
CO$121.921
CT$123.881
DC$134.001
DE$114.731
FL$112.40–$121.833
GA$105.91–$117.752
GU$128.331
HI$128.331
IA$107.031
ID$107.611
IL$108.40–$119.634
IN$108.291
KS$106.131
KY$105.261
LA$104.94–$110.492
MA$120.97–$134.962
MD$117.13–$134.003
ME$107.81–$114.552
MI$107.82–$113.502
MN$117.711
MO$102.78–$111.353
MS$102.371
MT$115.901
NC$109.061
ND$115.111
NE$107.771
NH$119.621
NJ$125.55–$132.412
NM$108.301
NV$115.771
NY$110.76–$136.245
OH$107.661
OK$105.451
OR$115.12–$126.402
PA$108.05–$120.402
PR$116.921
RI$119.261
SC$108.491
SD$115.011
TN$106.651
TX$107.27–$121.298
UT$110.071
VA$113.90–$134.002
VI$116.921
VT$114.291
WA$120.87–$138.172
WI$110.991
WV$104.051
WY$115.551

See 92511 in every payment locality

How the 92511 rate is calculated

Each of 92511’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 · 92511

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense2.84

2.84 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

3.4700

Conversion factor

$33.4009

Medicare rate

$115.90

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,781

Code
92511
Physician work
0.59
Practice expense
2.84
Malpractice
0.04

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 92511 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0540.6219
Practice expense2.84× 1.1783.3455
Malpractice0.04× 1.1130.0445
Total RVUs4.0119
Conversion factor× 33.4009

Office rate, Washington, DC area$134.00

Office: (0.59 × 1.054 + 2.84 × 1.178 + 0.04 × 1.113) × $33.4009 = $134.00

Facility: (0.59 × 1.054 + 0.35 × 1.178 + 0.04 × 1.113) × $33.4009 = $36.03

Open 92511 in the RVU calculator

Payment rules and modifiers for 92511

The CMS indicators that decide how 92511 is paid alongside other services.

CMS payment indicators · 92511

Nasopharyngoscopy, endoscopic nasopharynx exam

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

Codes related to 92511

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 92511
CodeHow it relatesOffice range, Washington, DC area
Used instead
31231Nasal endoscopy, diagnostic, without sinusoscopyDiagnostic nasal endoscopy is directed to the nasal cavity rather than the nasopharynx.$223.04
92512Nasal function test, airflow and resistanceNasal function studies assess airflow or nasal function rather than directly visualizing the nasopharynx.$74.40
92502ENT examination, under general anesthesiaA broader ENT examination under general anesthesia may fit when that is the service performed.No office rate

How 92511 has changed in Washington, DC area

92511 · Office / nonfacility

$134.00

Effective 2026-10-01

The base rate is $3.29 higher than on 2025-10-01, moving from $130.71 to $134.00 (2.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $130.71changed to$134.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.61 changed to 0.59
    • Practice expense RVU 2.81 changed to 2.84
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $136.90changed to$130.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.87 changed to 2.81

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $134.66changed to$136.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $142.39changed to$134.66

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.89 changed to 2.87
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $147.23changed to$142.39

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.88 changed to 2.89
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $145.00changed to$147.23

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.80 changed to 2.88

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $136.44changed to$145.00

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.52 changed to 2.80
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $133.36changed to$136.44

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.50 changed to 2.52
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $130.61changed to$133.36

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.44 changed to 2.50

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $131.58changed to$130.61

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.47 changed to 2.44
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $133.94changed to$131.58

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.53 changed to 2.47
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $163.44changed to$133.94

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.20 changed to 2.53

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $162.62changed to$163.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $162.89changed to$162.62

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.22 changed to 3.20
    • Malpractice RVU 0.03 changed to 0.04
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $169.25changed to$162.89

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.59 changed to 3.22
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $169.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$134.00$36.03RVU26D
2026-07-01$134.00$36.03RVU26C
2026-04-01$134.00$36.03RVU26B
2026-01-01$134.00$36.03RVU26A
2025-10-01$130.71$41.26RVU25D
2025-07-01$130.71$41.26RVU25C
2025-04-01$130.71$41.26RVU25B
2025-01-01$130.71$41.26RVU25A
2024-10-01$136.90$42.06RVU24D
2024-07-01$136.90$42.06RVU24C
2024-04-01$136.90$42.06RVU24B
2024-03-09$136.90$42.06RVU24AR
2024-01-01$134.66$41.38RVU24A
2023-10-01$142.39$42.83RVU23D
2023-07-01$142.39$42.83RVU23C
2023-04-01$142.39$42.83RVU23B
2023-01-01$142.39$42.83RVU23A
2022-10-01$147.23$43.29RVU22D
2022-07-01$147.23$43.29RVU22C
2022-04-01$147.23$43.29RVU22B
2022-01-01$147.23$43.29RVU22A
2021-10-01$145.00$42.79RVU21D
2021-07-01$145.00$42.79RVU21C
2021-04-01$145.00$42.79RVU21B
2021-01-01$145.00$42.79RVU21A
2020-10-01$136.44$43.91RVU20D
2020-07-01$136.44$43.91RVU20C
2020-04-01$136.44$43.91RVU20B
2020-01-01$136.44$43.91RVU20A
2019-10-01$133.36$43.46RVU19D
2019-07-01$133.36$43.46RVU19C
2019-04-01$133.36$43.46RVU19B
2019-01-01$133.36$43.46RVU19A
2018-10-01$130.61$42.98RVU18D
2018-07-01$130.61$42.98RVU18C
2018-04-01$130.61$42.98RVU18B
2018-01-01$130.61$42.98RVU18AR1
2017-10-01$131.58$43.36RVU17D
2017-07-01$131.58$43.36RVU17C
2017-04-01$131.58$43.36RVU17B
2017-01-01$131.58$43.36RVU17A
2016-10-01$133.94$45.07RVU16D
2016-07-01$133.94$45.07RVU16C
2016-04-01$133.94$45.07RVU16B
2016-01-01$133.94$45.07RVU16A
2015-10-01$163.44$56.49RVU15D
2015-07-01$163.44$56.49RVU15C
2015-04-01$162.62$56.20RVU15B
2015-01-01$162.62$56.20RVU15A
2014-10-01$162.89$56.10RVU14D
2014-07-01$162.89$56.10RVU14C
2014-04-01$162.89$56.10RVU14B
2014-01-01$162.89$56.10RVU14A
2013-10-01$169.25$55.94RVU13D
2013-07-01$169.25$55.94RVU13C
2013-04-01$169.25$55.94RVU13B
2013-01-01$169.25$55.94RVU13AR

Price 92511 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

92511 billing questions

How is 92511 different from diagnostic nasal endoscopy?

92511 is selected when the documented endoscopic examination reaches the nasopharynx. A nasal endoscopy code such as 31231 is directed to examination of the nasal cavity.

Can modifier 50 be used when both sides are examined?

No. CMS identifies bilateral adjustment as inappropriate for 92511; do not use modifier 50 to represent examination through both nostrils.

What documentation supports reporting 92511?

Document the clinical reason for the examination, the endoscopic approach, the nasopharyngeal structures visualized, and the findings. The note should support that the examination extended beyond the nasal cavity.

Is same-day preoperative or postoperative care included?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documented medical necessity. CMS does not permit co-surgeons or team surgery for this code.

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
RVUs for 92511PPRRVU2026_Oct_nonQPP.csv, line 11,781 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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