ENT (Otolaryngology) CPT Codes
ENT spans three organ systems, so its codes scatter across the Respiratory and Auditory subsections of Surgery plus the audiology tests in Medicine. The office side runs on scopes and cerumen removal, each with famously specific billing rules; the surgical side runs on globals. The specialty's most-argued code is also its smallest: earwax.
Reviewed by the ClinicsFlows editorial team · How we source this
ENT CPT codes
Nasal Endoscopy, Diagnostic
Diagnostic rigid or flexible nasal endoscopy. Inherently bilateral; bundles into surgical sinus scopes.
Cerumen Removal, Impacted, with Instrumentation
Clinician removal of impacted earwax using instruments. Irrigation by staff is 69209.
Comprehensive Audiometry
Full hearing evaluation: pure tone air and bone plus speech testing.
Septoplasty
Surgical correction of the deviated septum. 90-day global period.
Tympanostomy Tubes, General Anesthesia
Ear tube placement under general anesthesia. Per ear; bilateral uses modifier 50.
Laryngoscopy, Flexible, Diagnostic
Flexible scope evaluation of the larynx. The standard office voice/airway exam.
Codes in blue have full detail pages with documentation requirements, billing mistakes, and FAQ.
ENT billing notes
69210 (cerumen removal) requires impacted cerumen removed with instrumentation by a clinician. Irrigation by staff is 69209, and routine wax cleaning during an exam isn't separately billable at all.
Diagnostic nasal endoscopy (31231) is inherently bilateral: one code covers both sides. It also bundles into surgical sinus endoscopies performed the same session.
Audiometry codes like 92557 are typically performed by audiologists. Who can bill them, and under whose number, depends on payer credentialing rules that trip up many ENT practices.
Septoplasty (30520) is functional surgery and carries a 90-day global. When done with cosmetic rhinoplasty, the functional and cosmetic components must be cleanly separated, because payers only cover the functional part.
Tympanostomy tubes (69436, with general anesthesia) is per ear: bilateral placement takes modifier 50 payer-permitting.
Frequently asked questions about ent billing
Why do cerumen removal claims deny so often?▼
Because 69210 has three requirements payers enforce strictly: the cerumen must be impacted, removal must use instrumentation, and a clinician must do it. Staff irrigation is 69209 at a lower rate, and simple wax wiped away during an exam is part of the visit, not a billable procedure.
Can I bill 31231 for scoping both sides of the nose?▼
It's one code total. 31231 is defined as inherently bilateral, so scoping both nasal cavities is a single unit with no bilateral modifier. And when a surgical sinus endoscopy happens in the same session, the diagnostic scope bundles into it.
How is septoplasty handled when combined with rhinoplasty?▼
Insurance covers the functional septoplasty (30520) when medical necessity like obstruction is documented; the cosmetic rhinoplasty portion is patient-pay. The operative note has to separate the two clearly, and practices typically collect the cosmetic fee before surgery.
Sources
- Code set structure and updates: American Medical Association — CPT
- Fee schedule and component billing rules: CMS Medicare Physician Fee Schedule
- How we research and verify: our editorial policy
CPT® is a registered trademark of the American Medical Association. Content on this page is original educational writing, not a reproduction of AMA-copyrighted descriptions. Verify codes and payer rules before billing.