| Code | Description | Amount |
|---|---|---|
| 02505 | EMERGENCY VISIT - OTOLARYNGOLOGY | $120.54 |
| 02507 | SUBSEQUENT OFFICE VISIT - OTOLARYNGOLOGY | $30.71 |
| 02508 | SUBSEQUENT HOSPITAL VISIT - OTOLARYNGOLOGY | $24.05 |
| 02509 | SUBSEQUENT HOME VISIT - OTOLARYNGOLOGY | $48.20 |
| 02510 | CONSULTATION - OTOLARYNGOLOGY | $76.68 |
| 02511 | CONSULTATION: WITH PURE TONE AUDIOGRAM | $92.06 |
| 02512 | CONSULTATION, SPECIAL FOR DIZZINESS | $163.80 |
| 02513 | MALIGNANCY MANAGEMENT-CONSULTATION | $107.23 |
| 02514 | REPEAT OR LIMITED CONSULTATION - OTOLARYNGOLOGY | $45.13 |
| 02515 | ALLERGY CONSULTATION - OTOLARYNGOLOGY | $142.99 |
| Code | Description | Amount |
|---|---|---|
| 02520 | AUDIOGRAM - PURE TONE (AC AND BC) | $15.22 |
| 02521 | AUDIOGRAM - SPEECH (SRT, PB, MCL) | $16.59 |
| 02525 | IMPEDANCE TEST | $8.90 |
| 02526 | COLD CALORICS TEST | $10.95 |
| 02527 | BITHERMAL TEST | $23.74 |
| 02528 | ELECTRONYSTAGMOGRAPHY - E.N.G. | $46.84 |
| 02530 | FUNCTIONAL TESTS - STENGER | $23.74 |
| 02531 | IMPEDANCE TEST,INCLUDING CONTRALATERAL REFLEX | $17.53 |
| 02532 | PI-PB TEST | $6.15 |
| 02533 | AUDIOMETRY - PLAY | $23.74 |
| 02534 | AUDIOMETRY - FREE FIELD | $23.74 |
| 02535 | MAXILLARY SINUS ENDOSCOPY VIA CANINE FOSSA | $115.14 |
| 02536 | AUDIOMETRY - BRAINSTEM EVOKED RESPONSE | $46.51 |
| 02538 | LARYNGOSTROBOSCOPY | $72.41 |
| 02539 | AUDIOMETRY-BRAINSTEM E R WITH ELECTROCOCHLEOGRAPHY | $67.20 |
| 02540 | FLEXIBLE NASOPHARYNGOSCOPY WITH VIDEO FLUOROSCOPY | $61.89 |
| 02541 | ELECTROCOCHLEOGRAPHY | $50.66 |
| 02542 | AUTOACOUSTIC EMISSIONS - MEASUREMENT OF | $31.66 |
| Code | Description | Amount |
|---|---|---|
| 02206 | REMOVAL OF EAR CANAL OSTEOMA | $81.70 |
| 02209 | REMOVAL OF OBSTRUCTING EXOSTOSIS OF EAR CANAL | $477.58 |
| 02210 | PARACENTESIS OF THE EAR DRUM (OPERATION ONLY) | $43.99 |
| 02221 | MICROSCOPIC DEBRIDEMENT OR ... REMOVAL-EAR-L/A | $26.71 |
| 02223 | MICROSCOPIC DEBRIDEMENT OR ... REMOVAL-EAR G/A | $62.82 |
| 02224 | SEMICIRCULAR CANAL OCCLUS-TRANSCANAL LABRINTHOTOMY | $215.63 |
| 02231 | STENOSIS-SOFT TISSUE-EXTERNAL EAR,MICROSURGICAL | $522.81 |
| 02233 | FACIAL NERVE DECOMPRESSION-TRANSMASTOID,..SEGMENTS | $1,111.03 |
| 02234 | FACIAL NERVE DECOMPRESSION - TRANSMASTOID/VERTICAL | $578.15 |
| 02239 | TYMPANOTOMY-WITH OSSICULAR CHAIN RECONSTRUCTION | $351.89 |
| 02241 | LABYRINTHECTOMY-DRILL OUT OF PETROUS BONE | $565.55 |
| 02242 | ATRESIA-SOFT TISSUE-EXTERNAL EAR CANAL,MICROSURGIC | $784.24 |
| 02243 | REPAIR ATRESIA EXTERNAL EAR CANAL, COMPLETE, BONY | $1,043.13 |
| 02244 | REPAIR STENOSIS EXTERNAL EAR CANAL, BONY | $603.26 |
| 02245 | STENOSIS-SOFT TISSUE-EXTERNAL EAR CANAL,MICROSURGI | $653.53 |
| 02246 | STAPES-RECONSTRUCTION WITH LASER | $653.53 |
| 02247 | MASTOIDECTOMY - PARTIAL, CANAL WALL UP (CORTICAL) | $603.26 |
| 02248 | RADICAL MASTOIDECTOMY | $766.63 |
| 02249 | STAPES - RECONSTRUCTION | $603.26 |
| 02250 | STAPES - MOBILIZATION OF | $351.89 |
| 02251 | MYRINGOPLASTY REPAIR OF DRUM WITHOUT EXPLORATION | $188.51 |
| 02252 | TYMPANOPLASTY-WITHOUT OSSICULAR CHAIN RECONSTRUCT | $439.88 |
| 02253 | TYMPANOMASTOIDECTOMY - COMPLETE, CANAL WALL DOWN | $1,018.01 |
| 02254 | MYRINGOTOMY WITH INSERTION OF AERATING TUBE | $81.70 |
| 02255 | EXPLORATORY TYMPANOTOMY | $232.52 |
| 02256 | ENDOLYMPHATIC SHUNT (ANY PROCEDURE) | $854.60 |
| 02259 | GLOMUS EXCISION - BY TYMPANOTOMY | $666.10 |
| 02260 | GLOMUS EXCISION, EXTENSIVE DISSECTION IS REQUIRED | $863.16 |
| 02261 | EXPLORATORY TYMPANOTOMY WITH CHEMICAL CONTROL | $383.32 |
| 02263 | TRANS-TYMPANIC POLYNEURECTOMY | $326.76 |
| 02264 | TYMPANOPLASTY- WITH OSSICULAR CHAIN RECONSTRUCTION | $666.10 |
| 02265 | TYPANOMASTOIEDECTOMY - PARTIAL, CANAL WALL DOWN | $603.26 |
| 02266 | MYRINGOPLASTY - PAPER PATCH OR SYNTHETIC | $43.99 |
| 02267 | CONCHAL CARTILAGE GRAFT | $314.18 |
| 02268 | INTRA-COCHLEAR IMPLANT | $955.16 |
| 02269 | IMPLANTABLE BONE CONDUCTOR | $462.70 |
| 02270 | SEMICIRCULAR CANAL OCCLUSION- TRANSMASTOID | $784.24 |
| 02271 | FACIAL NEUROMA-TRANSMASTOID MICROSURGICAL REMOVAL | $1,960.59 |
| 02272 | TUMOR - MIDDLE EAR/MASTOID - MICROSURGICAL REMOVAL | $1,176.35 |
| 02273 | TYMPANOMASTOIDECTOMY-COMPLETE, MICROSURGICAL | $1,111.03 |
| 02274 | MYRINGOTOMY W INSERTION AERATING TUBE-BILATERAL | $125.68 |
| 02276 | TYMPANOPLASTY-LATERAL GRAFT,HOMOGRAFT TYMPANIC MEM | $666.10 |
| Code | Description | Amount |
|---|---|---|
| 02298 | CRYOSURGICAL TREATMENT OF TURBINATES - UNILATERAL | $150.81 |
| 02299 | CRYOSURGICAL TREATMENT OF TURBINATES - BILATERAL | $188.51 |
| 02301 | REMOVAL OF FOREIGN BODY FROM NOSE - COMPLICATED | $62.82 |
| 02303 | CAUTERIZATION OF SEPTUM - ELECTRIC | $37.69 |
| 02304 | TURBINECTOMY - UNILATERAL | $94.25 |
| 02305 | TURBINECTOMY - BILATERAL | $138.24 |
| 02306 | SUBMUCOUS RESECTION OF SEPTUM | $163.37 |
| 02307 | NASO-ANTRAL WINDOW - SINGLE | $113.11 |
| 02308 | NASO-ANTRAL WINDOW - DOUBLE | $175.95 |
| 02309 | RADICAL ANTROSTOMY | $314.18 |
| 02310 | RADICAL ANTROSTOMY WITH CLOSURE OF ALVEOLAR FISTUL | $452.45 |
| 02315 | EXTERNAL RADICAL FRONTO - ETHMOIDECTOMY | $578.15 |
| 02317 | ELECTROCOAGULATION OF TURBINATES - ONE SIDE | $50.27 |
| 02318 | ELECTROCOAGULATION OF TURBINATES - BOTH SIDES | $75.40 |
| 02319 | TREPHINING FRONTAL SINUS | $251.36 |
| 02321 | SINUS SPHENOIDOTOMY (INTRANASAL) | $263.93 |
| 02322 | REMOVAL OF NASAL POLYPI- UNILATERAL | $100.55 |
| 02323 | REMOVAL OF NASAL POLYPI- BILATERAL | $163.37 |
| 02324 | ANTRAL LAVAGE - UNILATERAL | $33.08 |
| 02325 | ANTRAL LAVAGE - BILATERAL | $49.61 |
| 02326 | CHOANAL ATRESIA; DEFINITIVE REPAIR OF - UNILATERAL | $477.58 |
| 02327 | CHOANAL ATRESIA ; DEFINITIVE REPAIR OF - BILATERAL | $666.10 |
| 02328 | CHOANAL ATRESIA; PERFORATION OF - UNILATERAL | $163.37 |
| 02329 | CHOANAL ATRESIA PERFORATION OF - BILATERAL | $226.21 |
| 02330 | SUBMUCOUS TURBINECTOMY - UNILATERAL | $163.37 |
| 02331 | SUBMUCOUS TURBINECTOMY - BILATERAL | $251.36 |
| 02332 | LATERAL RHINOTOMY AND EXCISION OF TUMOUR - BENIGN | $578.15 |
| 02333 | LAT RHINOTOMY/MEDIAL MAXILLECTOMY FOR EXIS TUMOUR | $615.83 |
| 02334 | TRANSANTRAL ETHMOIDECTOMY | $477.58 |
| 02335 | TRANSANTRAL LIGATION, INTERNAL MAXILLARY ARTERY | $502.72 |
| 02336 | STENOSIS - CHOANAL - LASER REVISION | $130.71 |
| 02337 | LIGATION OF ANTERIOR AND POSTERIOR ETHMOID ARTERIE | $314.18 |
| 02338 | REMOVAL OF ANGIOFIBROMA - NASAL PHARYNX | $728.93 |
| 02339 | PALATAL FENESTRATION | $253.99 |
| 02341 | NASAL PACKING - POSTERIOR (OPERATION ONLY) | $62.82 |
| 02342 | MAXILLECTOMY WITH EXENTERATION OF ETHMOID | $791.78 |
| 02343 | SEPTAL RECONSTRUCTION | $377.04 |
| 02345 | DRAINAGE OF ABSCESS OR HAEMATOMA OF SEPTUM | $113.11 |
| 02346 | NASAL PACKING-POSTERIOR/WITH ANAESTHETIC | $98.02 |
| 02347 | OSTEOPLASTIC FRONTAL FLAP OPERATION - EXTERNAL | $917.48 |
| 02348 | ORAL NASAL FISTULA - OPERATIVE CLOSURE | $351.89 |
| 02349 | NASAL SEPTAL PERFORATION - OPERATIVE CLOSURE | $502.72 |
| 02357 | SINUS SURGERY- FUNCTIONAL - ENDOSCOPIC - <14 YEARS | $314.20 |
| 02358 | SINUSOTOMY - FRONTAL - ENDOSCOPIC - REVISION | $457.48 |
| 02359 | SPHENO-ETHMOIDOTOMY/INTRANASAL/ENDOSCOPIC/REVISION | $522.81 |
| 02360 | ETHMOIDOTOMY-INTRANASAL-POSTERIOR-UNILATERAL | $351.89 |
| 02361 | ETHMOIDOTOMY-INTRANASAL-POSTERIOR-BILATERAL | $540.42 |
| 02362 | ETHMOIDOTOMY -INTRANASAL - ANTERIOR - UNILATERAL | $188.51 |
| 02363 | ETHMOIDOTOMY-INTRANASAL-ANTERIOR- BILATERAL | $314.18 |
| 02364 | NASAL FRACTURE - SIMPLE REDUCTION | $62.82 |
| 02365 | NASAL FRACTURE - REDUCTION AND SPLINTING | $125.68 |
| 06123 | NASAL FRACTURE-COMMINUTED-WIRE PLATE FIXATION | $302.49 |
| 25100 | LASER PHOTOCOAGULATION OF HHT LESIONS NASAL CAVITY | $439.47 |
| 25300 | ENDOSCOPIC STEREOTACTIC RESECTION OF INTRANASAL | $1,030.82 |
| 25301 | ENDOSCOP RESEC INTRANASAL/SINUS TUMOR-ADD AFTER 7 | $257.70 |
| 25305 | ENDOSCOPIC LIGATION - SPHENOPALATINE ARTERY | $412.33 |
| 25310 | ENDOSCOP TRANS-NASAL REPAIR CSF LEAK FRM ANT SKULL | $961.57 |
| 25315 | PRIMARY FRONTAL SINUSOTOMY | $228.84 |
| Code | Description | Amount |
|---|---|---|
| 02351 | NASAL REFRACTURE REQUIRING LATERAL OSTEOTOMIES | $351.89 |
| 02352 | RECONSTRUCTION OF NASAL TIP, ALA AND COLUMELLA | $414.74 |
| 02353 | NASAL TIP, ALA AND COLUMELLA/EXTERNAL RECONSTRUCT | $555.51 |
| 02354 | RHINOPLASTY/COMPLETE - WITH SMR TO INCLUDE NASAL | $603.26 |
| 02355 | RHINOPLASTY/SMR, COMPLETE - WITHOUT SKIN GRAFTING | $764.64 |
| Code | Description | Amount |
|---|---|---|
| 02399 | CRYOTHERAPY OF TONSILS AND ORAL LESIONS | $113.11 |
| 02403 | TONSILLECTOMY - UNDER LA | $253.87 |
| 02406 | RETROPHARYNGEAL ABSCESS OR HEMATOMA - REQUIRING | $238.77 |
| 02408 | REMOVAL OF TUMOR FROM LARYNX OR TRACHEA | $188.51 |
| 02409 | UVULO-PALATO-PHARYNGOPLASTY FOR OBSTRUCTIVE | $414.74 |
| 02410 | THYROTOMY | $502.72 |
| 02413 | OPERATIVE CONTROL OF POST-TONSILLECTOMY HAEMORRHAG | $163.37 |
| 02414 | LARYNGO TRACHEAL STENOSIS- REPAIR, INCLUDES .. | $1,420.17 |
| 02418 | FRACTURED LARYNX -REPAIR - EXTERNAL APPROACH | $816.91 |
| 02420 | DILATION OF TRACHEA | $81.70 |
| 02421 | DILATION OF TRACHEA - REPEAT WITHIN ONE MONTH | $37.69 |
| 02422 | BRONCHO OR MICROLARYNGOSCOPY W F B REMOVAL- <3 YRS | $374.93 |
| 02424 | TRACHEOESOPHAGEAL PUNCTURE AND INSERTION OF VOICE | $351.89 |
| 02425 | ARYTENOIDECTOMY | $628.41 |
| 02431 | HEMILARYNGECTOMY | $1,426.10 |
| 02432 | SUPRAGLOTTIC LARYNGECTOMY | $1,551.91 |
| 02433 | VOCAL CORD IMPLANT - INJECTION | $314.18 |
| 02434 | VOCAL CORD IMPLANT - EXTERNAL APPROACH | $628.41 |
| 02437 | TRANSPHENOIDAL REMOVAL OF PITUITARY TUMOR OR | $1,215.45 |
| 02438 | TRANS-ORAL CRICOPHARYNGEAL MYOTOMY | $414.74 |
| 02440 | SUBMANDIBULAR SALIVARY DUCTS - MICRO-TRANSPOSITION | $333.32 |
| 02441 | STANDBY FEE- ENT | $294.10 |
| 02442 | ADENOIDECTOMY - ADULT OR CHILD OVER 14 YEARS | $126.90 |
| 02443 | ADENOIDECTOMY - 14 YEARS AND UNDER | $155.86 |
| 02444 | INCISION OF PERITONSILLAR ABSCESS-GENERAL ANAESTHE | $126.90 |
| 02445 | TONSILLECTOMY - OVER 14 YEARS OF AGE | $210.95 |
| 02446 | TONSILLECTOMY -14 YEARS AND UNDER(INCLUDES NEONATE | $188.85 |
| 02447 | INCISION OF PERITONSILLAR ABSCESS-LOCAL ANAESTHETI | $50.27 |
| 02448 | RETROPHARYNGEAL ABSCESS OR HEMATOMA-DRAINAGE UNDER | $125.68 |
| 02449 | OESOPHAGOSCOPY-RIGID FOR REMOVAL OF FOREIGN BODY | $188.51 |
| 02450 | BRONCHO OR MICROLARYNGOSCOPY W REMOVAL F BODY | $251.36 |
| 02451 | CONGENITAL CYST/FISTULA - EXCISION, NECK | $414.74 |
| 02452 | SIALOLITHOTOMY - SIMPLE IN DUCT | $62.82 |
| 02453 | SIALOLITHOTOMY - COMPLICATED IN GLAND | $188.51 |
| 02454 | ALVEOLECTOMY | $188.51 |
| 02455 | EXCISION OF SUBMANDIBULAR GLAND | $314.18 |
| 02456 | FISTULA - SALIVARY -PLASTIC TO STENSON'S DUCT | $414.74 |
| 02457 | TONGUE TIE, G.A. | $81.70 |
| 02458 | TONGUE - LOCAL EXCISION/GA | $163.37 |
| 02459 | EXCISION CYSTIC HYGROMA | $540.42 |
| 02436 | ARYTENOID ADDUCTION | $800.00 |
| Code | Description | Amount |
|---|---|---|
| 02412 | BIOPSY OF LARYNX AND/OR CAUTERIZATION | $125.68 |
| 02419 | LARYNGOSCOPY-DIRECT OR INDIRECT-WITH F B REMOVAL | $150.81 |
| 02423 | MICROLARYNGOSCOPY W REMOVAL MALIGNANCY OR ..LESION | $438.84 |
| 02428 | MICRO-LARYNGOSCOPY W BIOPSY OF LARYNX AND/OR CAUT | $175.95 |
| 02429 | MICRO-LARYNGOSCOPY & REMOVAL OF TUMOR FROM LARYNX | $201.09 |
| 02430 | MICRO-SURGERY W CO2 LASER FOR REMOVAL OF-1ST PROC | $438.84 |
| 02435 | MICROSURGERY W C02 LASER FOR ..-SUBSEQUENT PROC | $438.84 |
| Code | Description | Amount |
|---|---|---|
| 02262 | TRANSLABYRINTHINE APPROACH FOR NEUROSURGICAL | $1,905.74 |
| 02610 | MIDDLE CRANIAL FOSSA APPROACH WITHOUT PETROSECTOMY | $1,418.93 |
| 02612 | MIDDLE CRANIAL FOSSA APPROACH - PETROSECTOMY | $1,901.11 |
| 02613 | MIDDLE CRANIAL FOSSA APPROACH-PETROSECTOMY-> 8HRS | $2,376.26 |
| 02614 | RETROLABYRINTHINE APPROACH - NEUROSURGICAL ACCESS | $1,188.09 |
| 02618 | CSF LEAK REPAIR | $950.90 |
| 02622 | INFRA-TEMPORAL FOSSA APPROACH TO SKULL BASE | $1,901.11 |
| 02623 | INFRA-TEMPORAL FOSSA APPROACH TO SKULL BASE >8 HRS | $2,376.26 |
| Code | Description | Amount |
|---|---|---|
| 00701 | DIRECT LARYNGOSCOPY | $37.14 |
| 00717 | MICRO-LARYNGOSCOPY | $74.27 |
| 00745 | PERIPHERAL OR SUBCUTANEOUS LYMPH NODE BIOPSY | $47.48 |
| 00907 | ENDOSCOPIC EXAM OF NOSE AND NASOPHARYNX | $32.58 |
| 00908 | ENDOSCOPIC EXAM AND BIOPSY OF SINUS | $52.11 |
| 00909 | FLEXIBLE FIBEROPTIC NASOPHARYNGOLARYNGOSCOPY | $38.49 |
| 10762 | RIGID ESOPHAGOSCOPY | $73.62 |
| Code | Description | Amount |
|---|---|---|
| 02275 | GLOSSECTOMY - SUBTOTAL | $1,040.54 |
| 02279 | RESECTION-BASE OF TONGUE &/OR TONSIL/SOFT PALATE | $1,897.77 |
| 02280 | CRANIO-FACIAL RESECTION -OTOLARYNGEAL COMPONENT | $2,376.49 |
| 02281 | CONSERVATIVE RADICAL NECK DISSECTION | $1,236.59 |
| 02282 | TONGUE/MANDIBLE - COMPOSITE RESECTION AND ... | $1,897.77 |
| 02407 | TRACHEOTOMY | $337.51 |
| 02411 | LARYNGECTOMY, TOTAL | $1,300.26 |
| 02431 | HEMILARYNGECTOMY | $1,426.10 |
| 02432 | SUPRAGLOTTIC LARYNGECTOMY | $1,551.91 |
| 02470 | RADICAL NECK DISSECTION | $1,040.60 |
| 02471 | SUBTOTAL PAROTIDECTOMY W FACIAL NERVE DISSECTION | $829.51 |
| 02472 | TOTAL PAROTIDECTOMY .. FOR MALIGNANCY OR DEEP LOBE | $955.16 |
| 02473 | LARYNGO-PHARYNGO-OESOPHAGECTOMY - PRIMARY EXCISION | $1,560.87 |
| 02474 | TRANSORAL MAXILLECTOMY WITH SKIN GRAFT | $1,040.57 |
| 02476 | RE-ESTABLISHMENT IN NECK | $628.41 |
| 02477 | SUPRAHYOID DISSECTION - CONTRALATERAL | $477.58 |
| 02478 | GLOSSECTOMY - PARTIAL FOR CARCINOMA | $364.47 |
| 02479 | TRANSPALATAL ETHMOIDECTOMY/MAXILLECTOMY/SPHENOIDE | $1,300.63 |
| 02480 | MANDIBLE/ FLOOR OF MOUTH-RESECTION FOR MALIGNANCY | $1,300.63 |
| 02600 | TEMPORAL BONE RESECTION - COMPLETE, ENT FEE | $2,376.49 |
| 02601 | TEMPORAL BONE RESECTION - SUBTOTAL AND LATERAL | $1,188.22 |