$28.45
92502 is a broad otolaryngologic examination under general anesthesia; 92504 is a separate diagnostic ear examination using binocular microscopy.
On this page
CMS RVU26D · Effective 2026-10-01
92502 ENT examination Medicare reimbursement rates in Delaware
A broad ear, nose, and throat examination performed under general anesthesia when a complete diagnostic assessment cannot be completed while the patient is awake. Compare 92502 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92502 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$85.98
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Otolaryngology examination
About 92502: Otolaryngologic examination under general anesthesia
A broad ear, nose, and throat examination performed under general anesthesia when a complete diagnostic assessment cannot be completed while the patient is awake.
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.
CMS billing rules for 92502
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.47 · 57%
- Practice expense (office) RVU1.01 · 39%
- Malpractice RVU0.11 · 4%
657
Medicare services in 2024 · #3322 by national volume
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.
92502 compared with similar codes
Office rates for Delaware, from the same CMS release.
$114.73
92511 is a focused endoscopic examination of the nasopharynx, not a broad examination of the ear, nose, and throat under general anesthesia.
$125.87
31575 describes flexible diagnostic laryngoscopy focused on the larynx. Choose 92502 when the service is a broader otolaryngologic examination under general anesthesia.
Compare 92502 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$85.98
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92502 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
11,777
- Code
- 92502
- Physician work
- 1.47
- Practice expense
- 1.01
- Malpractice
- 0.11
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.47 | × 1.005 | 1.4773 |
| Practice expense | 1.01 | × 0.988 | 0.9979 |
| Malpractice | 0.11 | × 0.899 | 0.0989 |
| Total RVUs | 2.5741 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$85.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.47 | 1.005 |
| Practice expense | 1.01 | 0.988 |
| Malpractice | 0.11 | 0.899 |
(1.47 × 1.005 + 1.01 × 0.988 + 0.11 × 0.899) × $33.4009 = $85.98
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,77492499,,Unlisted oph svc/procedure,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77592499,26,Unlisted oph svc/procedure,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77692499,TC,Unlisted oph svc/procedure,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77792502,,Ear and throat examination,A,,1.47,1.01,NA,1.01,,0.11,2.59,2.59,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77892504,,Ear microscopy examination,A,,0.18,0.67,,0.04,,0.01,0.86,0.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77992507,,Tx sp lang voice comm indiv,A,,1.30,0.97,,0.97,NA,0.01,2.28,2.28,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,78092508,,Tx sp lang voice comm group,A,,0.33,0.38,,0.38,NA,0.01,0.72,0.72,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503