📋Otolaryngology CPT Codes Reference
What This MOC Covers
This reference index covers the major CPT code families in Otolaryngology (ENT) — organized by anatomic region and procedure type. Use this note to navigate to individual procedure notes, identify correct code selection within a family, understand bundling rules, and locate modifier and global period guidance. Codes span the Ear, Nose, Throat, Larynx, Trachea, Salivary Glands, and Head/Neck Surgery sections of CPT.
💰 Anatomic Navigation Index
- 👂 Ear — External Ear
- 👂 Ear — Middle Ear
- 👂 Ear — Inner Ear
- 👂 Ear — Temporal Bone and Mastoid
- 👃Nose — Excision and Repair
- 👃Nose — Excision and Repair
- Nose — Septum
- Nose — Turbinates
- Nose — Epistaxis Control
- Nose — Nasal Endoscopy (FESS)
- FESS Building-Block Coding Model
- Larynx and Trachea
- Pharynx and Adenoids
- Tonsils
- Salivary Glands
- Mouth and Oral Cavity
- Head and Neck — Excision and Neck Dissection
- MS-DRG Reference
- Global Period Quick Reference
- Modifier Quick Reference — ENT
👂 Ear — External Ear
| CPT | Description | Global | Notes |
|---|---|---|---|
| 69000 | Drainage of external ear, abscess or hematoma; simple | 010 | Incision and drainage, external auditory canal |
| 69005 | Drainage of external ear, abscess or hematoma; complicated | 010 | Deep or complex EAC abscess |
| 69020 | Drainage of external auditory canal, abscess | 010 | Canal abscess |
| 69090 | Ear piercing | 000 | Minor procedure |
| 69100 | Biopsy of external ear | 000 | Skin or cartilage biopsy |
| 69105 | Biopsy of external auditory canal | 000 | EAC lesion biopsy |
| 69110 | Excision of external ear, partial, simple repair | 090 | Partial auriculectomy |
| 69120 | Excision of external ear, complete amputation | 090 | Total auriculectomy |
| 69140 | Excision, exostosis of external auditory canal | 090 | Surfer’s ear |
| 69145 | Excision, soft tissue lesion, external auditory canal | 090 | EAC soft tissue |
| 69150 | Radical excision, external auditory canal lesion, without neck dissection | 090 | Malignant EAC lesion |
| 69155 | Radical excision of external auditory canal lesion, with neck dissection | 090 | With LND |
| 69200 | Removal of foreign body, external auditory canal; without general anesthesia | 000 | FB removal, office |
| 69205 | Removal of foreign body, external auditory canal; with general anesthesia | 000 | FB removal, OR |
| 69209 | Removal of impacted cerumen, irrigation or instrumentation; unilateral | 000 | Lavage/irrigation only |
| 69210 | Removal of impacted cerumen requiring instrumentation; unilateral | 000 | Curette/suction; bilateral = -50 |
| 69220 | Debridement, mastoidectomy cavity; simple | 010 | Mastoid bowl cleaning |
| 69222 | Debridement, mastoidectomy cavity; complex | 010 | Extensive debridement |
| 69300 | Otoplasty | 090 | Cosmetic/reconstructive ear pinning |
👂 Ear — Middle Ear
Myringotomy and Tube Insertion
| CPT | Description | Global | Notes |
|---|---|---|---|
| 69420 | Myringotomy including aspiration and/or Eustachian tube inflation | 010 | No tube inserted |
| 69421 | Myringotomy including aspiration, with general anesthesia | 010 | Aspiration under GA, no tube |
| 69433 | Tympanostomy, local or topical anesthesia | 010 | Tube insertion, local anesthesia — office |
| 69436 | Tympanostomy, general anesthesia | 010 | Tube insertion under GA; bilateral = -50 |
| 69440 | Middle ear exploration through postauricular or ear canal incision | 090 | Exploration |
| 69450 | Tympanolysis, transcanal | 090 | Lysis of tympanic membrane adhesions |
Tympanoplasty
| CPT | Description | Global | Notes |
|---|---|---|---|
| 69610 | Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch | 090 | Simple patch repair |
| 69620 | Myringoplasty (Type I tympanoplasty) | 090 | Graft-only repair, no ossicular work |
| 69631 | Tympanoplasty without mastoidectomy; with ossicular chain reconstruction | 090 | Includes PORP |
| 69632 | Tympanoplasty without mastoidectomy; with ossicular chain reconstruction and synthetic prosthesis | 090 | TORP or synthetic |
| 69633 | Tympanoplasty without mastoidectomy; with perilymph fistula repair | 090 | Fistula repair |
| 69635 | Tympanoplasty with antrotomy or mastoidotomy; without ossicular chain reconstruction | 090 | With antral work, no ossicles |
| 69636 | Tympanoplasty with antrotomy or mastoidotomy; with ossicular chain reconstruction | 090 | With ossicular work |
| 69637 | Tympanoplasty with antrotomy or mastoidotomy; with ossicular chain reconstruction and synthetic prosthesis | 090 | Synthetic prosthesis |
| 69641 | Tympanoplasty with mastoidectomy; without ossicular chain reconstruction | 090 | Mastoidectomy + TMP |
| 69642 | Tympanoplasty with mastoidectomy; with ossicular chain reconstruction | 090 | Full reconstruction |
| 69643 | Tympanoplasty with mastoidectomy; intact or reconstructed canal wall, without ossicular chain reconstruction | 090 | CWU mastoidectomy |
| 69644 | Tympanoplasty with mastoidectomy; intact or reconstructed canal wall, with ossicular chain reconstruction | 090 | CWU + ossicular |
| 69645 | Tympanoplasty with mastoidectomy; radical or complete, without ossicular chain reconstruction | 090 | CWD mastoidectomy |
| 69646 | Tympanoplasty with mastoidectomy; radical or complete, with ossicular chain reconstruction | 090 | CWD + ossicular |
Middle Ear Other
| CPT | Description | Global | Notes |
|---|---|---|---|
| 69650 | Stapes mobilization | 090 | For otosclerosis — rare |
| 69660 | Stapedectomy or stapedotomy | 090 | Prosthetic stapes |
| 69661 | Stapedectomy or stapedotomy with reestablishment of ossicular continuity with or without use of foreign material | 090 | Full reconstruction |
| 69662 | Revision of stapedectomy or stapedotomy | 090 | Revision surgery |
| 69666 | Repair of oval window fistula | 090 | Oval window |
| 69667 | Repair of round window fistula | 090 | Round window |
| 69670 | Mastoid obliteration (separate procedure) | 090 | Cavity obliteration |
| 69676 | Tympanic neurectomy | 090 | Jacobson nerve — for Frey syndrome, parotid hyper-secretion |
Epistaxis/Nasopharyngeal Hemorrhage from Ear Surgery
| CPT | Description | Notes |
|---|---|---|
| 42960 | Control of nasopharyngeal hemorrhage; simple | Post-tonsillectomy bleed, simple |
| 42961 | Control of nasopharyngeal hemorrhage; requiring hospitalization | Requiring admission |
| 42962 | Control of nasopharyngeal hemorrhage; with secondary surgical intervention | Return to OR |
👂 Ear — Inner Ear
| CPT | Description | Global | Notes |
|---|---|---|---|
| 69801 | Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal | 090 | Gentamicin/steroid perfusion — Meniere’s |
| 69802 | Labyrinthotomy, with perfusion of vestibuloactive drug(s); with mastoidotomy | 090 | With mastoid access |
| 69805 | Endolymphatic sac operation; without shunt | 090 | Meniere’s surgical treatment |
| 69806 | Endolymphatic sac operation; with shunt | 090 | With drainage shunt |
| 69820 | Fenestration semicircular canal | 090 | Rare |
| 69840 | Revision of fenestration operation | 090 | Revision |
| 69905 | Labyrinthectomy; transcanal | 090 | Destructive — severe Meniere’s |
| 69910 | Labyrinthectomy; with mastoidectomy | 090 | With mastoid access |
| 69930 | Cochlear device implantation, with or without mastoidectomy | 090 | Cochlear implant (CI) surgery |
👂 Ear — Temporal Bone and Mastoid
| CPT | Description | Global | Notes |
|---|---|---|---|
| 69501 | Transmastoid antrotomy (simple mastoidectomy) | 090 | Simple mastoidectomy |
| 69502 | Mastoidectomy without tympanoplasty | 090 | Canal wall up, no TMP |
| 69505 | Mastoidectomy with tympanoplasty | 090 | Combined approach |
| 69511 | Mastoidectomy radical | 090 | Canal wall down — radical |
| 69530 | Petrous apicectomy including radical mastoidectomy | 090 | Petrous apex |
| 69535 | Resection of temporal bone, external approach | 090 | Temporal bone resection — malignancy |
| 69554 | Ablation of lateral semicircular canal; with mastoidectomy | 090 | Labyrinthine surgery |
👃 Nose — Incision, Drainage, Biopsy
| CPT | Description | Global | Notes |
|---|---|---|---|
| 30000 | Drainage of nasal abscess or hematoma; internal approach | 010 | Septal hematoma drainage |
| 30020 | Drainage of nasal abscess or hematoma; external approach | 010 | External approach |
| 30100 | Biopsy, intranasal | 000 | Office biopsy, nasal mucosa or lesion |
| 30110 | Excision of nasal polyp(s), simple | 010 | Simple office polypectomy |
| 30115 | Excision of nasal polyp(s), extensive | 090 | Extensive polypectomy, OR |
| 30117 | Excision or destruction, intranasal lesion; internal approach | 010 | Benign lesion excision |
| 30118 | Excision or destruction, intranasal lesion; external approach | 090 | External rhinotomy approach |
| 30124 | Excision dermoid cyst, nose; simple, not involving the nasal bone | 010 | Superficial dermoid |
| 30125 | Excision dermoid cyst, nose; complex, with osteotomies | 090 | Deep dermoid, bone work |
👃 Nose — Excision and Repair
| CPT | Description | Global | Notes |
|---|---|---|---|
| 30400 | Rhinoplasty; primary, tip only | 090 | Cosmetic — tip plasty |
| 30410 | Rhinoplasty; primary, except tip | 090 | Cosmetic — dorsum/bridge |
| 30420 | Rhinoplasty; primary, including major septal repair | 090 | Cosmetic with septal work |
| 30430 | Rhinoplasty; secondary, minor revision | 090 | Minor revision rhinoplasty |
| 30435 | Rhinoplasty; secondary, intermediate revision | 090 | Intermediate revision |
| 30450 | Rhinoplasty; secondary, major revision | 090 | Major revision rhinoplasty |
| 30460 | Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate; tip only | 090 | Cleft nose repair, tip |
| 30462 | Rhinoplasty for nasal deformity secondary to congenital cleft lip/palate; tip, septum, osteotomies | 090 | Full cleft nose repair |
| 30465 | Repair of nasal vestibular stenosis | 090 | Stenosis repair |
Tip
Nose — Septum
| CPT | Description | Global | Notes |
|---|---|---|---|
| 30520 | Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft | 090 | Functional septoplasty — most commonly billed septum CPT |
| 30600 | Repair of nasoseptal perforation | 090 | Septal perforation closure |
| 30630 | Repair of nasal septal perforations | 090 | Complex perforation repair |
Tip
Nose — Turbinates
| CPT | Description | Global | Notes |
|---|---|---|---|
| 30130 | Excision inferior turbinate, partial or complete, any method | 010 | Partial or complete turbinate excision |
| 30140 | Submucous resection inferior turbinate, partial or complete, unilateral or bilateral | 010 | Submucous resection — most commonly reported; separately reportable from 30520 |
| 30801 | Ablation, soft tissue of inferior turbinates, unilateral or bilateral; superficial | 010 | Radiofrequency or laser superficial ablation |
| 30802 | Ablation, soft tissue of inferior turbinates, unilateral or bilateral; intramural | 010 | Intramural radiofrequency — somnoplasty-type |
| 30930 | Fracture nasal inferior turbinate(s), therapeutic | 010 | Outfracture or infracture |
Tip
⚠️ Turbinate billing note: Turbinate procedures are separately reportable when performed in conjunction with septoplasty (30520). The operative note must describe the turbinate procedure as a distinct, intentional surgical step with a separately documented indication. Do not bill turbinate codes for incidental repositioning only.
Nose — Epistaxis Control
| CPT | Description | Global | Notes |
|---|---|---|---|
| 30901 | Control of nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method | 010 | Initial anterior — office or ED |
| 30903 | Control of nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method | 010 | Subsequent/complex anterior |
| 30905 | Control of nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial service | 010 | Posterior nasal packing or balloon catheter |
| 30906 | Control of nasal hemorrhage, posterior; subsequent service | 010 | Follow-up posterior bleed management |
| 30999 | Unlisted procedure, nose | N/A | Used for endoscopic SPA ligation — see 31238 |
| 31238 | Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage | 010 | Endoscopic hemorrhage control — SPA cautery |
Nose — Nasal Endoscopy (FESS)
FESS Building-Block Coding Model
FESS codes are additive — each anatomic sinus opened and treated is separately reported. Each code builds upon the prior:
| CPT | Description | Global | Notes |
|---|---|---|---|
| 31231 | Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) | 000 | Diagnostic only — NOT reported when surgical FESS performed |
| 31233 | Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy | 000 | Diagnostic with maxillary visualization |
| 31235 | Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy | 000 | Diagnostic with sphenoid |
| 31237 | Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement | 010 | Surgical endoscopy with tissue |
| 31238 | Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage | 010 | Endoscopic hemorrhage — SPA |
| 31239 | Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy | 090 | Endoscopic DCR |
| 31240 | Nasal/sinus endoscopy, surgical; with concha bullosa resection | 010 | Middle turbinate air cell |
| 31241 | Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery | 010 | SPA ligation |
| 31254 | Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior) | 090 | Anterior ethmoidectomy only |
| 31255 | Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior) | 090 | Total ethmoidectomy — most common |
| 31256 | Nasal/sinus endoscopy, surgical; with maxillary antrostomy | 090 | Maxillary antrostomy without tissue removal |
| 31267 | Nasal/sinus endoscopy, surgical; with maxillary antrostomy, with removal of tissue from maxillary sinus | 090 | Maxillary antrostomy with tissue removal — most commonly billed maxillary code |
| 31276 | Nasal/sinus endoscopy, surgical; with frontal sinus exploration, with or without removal of tissue | 090 | Frontal sinusotomy |
| 31287 | Nasal/sinus endoscopy, surgical; with sphenoidotomy | 090 | Sphenoid sinusotomy |
| 31288 | Nasal/sinus endoscopy, surgical; with sphenoidotomy, with removal of tissue | 090 | Sphenoid with tissue removal |
| 31295 | Nasal/sinus endoscopy, surgical; dilation of maxillary sinus ostium (balloon) | 090 | Balloon sinuplasty — maxillary |
| 31296 | Nasal/sinus endoscopy, surgical; dilation of frontal sinus ostium (balloon) | 090 | Balloon sinuplasty — frontal |
| 31297 | Nasal/sinus endoscopy, surgical; dilation of sphenoid sinus ostium (balloon) | 090 | Balloon sinuplasty — sphenoid |
| 31298 | Nasal/sinus endoscopy, surgical; dilation of frontal and sphenoid sinus ostia (balloon) | 090 | Balloon sinuplasty — frontal + sphenoid |
FESS Bundling and Modifier Rules:
- Each sinus code is reported separately for the sinuses treated.
- Modifier -50 when the same sinus procedure is performed bilaterally.
- Modifier -51 for the secondary lower-value procedure when multiple different FESS codes are reported.
- 31231 (diagnostic endoscopy) is NOT separately billable when any surgical endoscopy code is used — bundled.
- Balloon sinuplasty (31295-31298) and conventional FESS codes (31254-31288) may be reported together when both approaches are used in the same session for different sinuses.
Larynx and Trachea
Laryngoscopy
| CPT | Description | Global | Notes |
|---|---|---|---|
| 31505 | Laryngoscopy, indirect; diagnostic | 000 | Mirror exam |
| 31510 | Laryngoscopy, indirect; with biopsy | 000 | Mirror with tissue |
| 31511 | Laryngoscopy, indirect; with removal of foreign body | 000 | FB removal |
| 31512 | Laryngoscopy, indirect; with removal of lesion | 000 | Lesion removal |
| 31520 | Laryngoscopy, direct, diagnostic; newborn | 000 | Newborn airway exam |
| 31525 | Laryngoscopy, direct, diagnostic; except newborn | 000 | Direct diagnostic |
| 31526 | Laryngoscopy, direct, diagnostic; with operating microscope or telescope | 000 | Micro-laryngoscopy, diagnostic |
| 31527 | Laryngoscopy, direct; with insertion of obturator | 000 | Obturator placement |
| 31528 | Laryngoscopy, direct; with dilation, initial | 000 | Initial dilation |
| 31529 | Laryngoscopy, direct; with dilation, subsequent | 000 | Subsequent dilation |
| 31530 | Laryngoscopy, direct; with removal of foreign body | 090 | OR foreign body |
| 31531 | Laryngoscopy, direct; with removal of foreign body, with operating microscope or telescope | 090 | Micro with FB |
| 31535 | Laryngoscopy, direct; with biopsy | 090 | Biopsy under direct scope |
| 31536 | Laryngoscopy, direct; with biopsy, with operating microscope or telescope | 090 | Micro-laryngoscopy with biopsy |
| 31540 | Laryngoscopy, direct; with excision of tumor and/or stripping of vocal cords or epiglottis | 090 | Tumor excision or cord stripping |
| 31541 | Laryngoscopy, direct; with excision of tumor, with operating microscope or telescope | 090 | Micro-laryngoscopy, tumor excision |
| 31545 | Laryngoscopy, direct; with vocal cord injection, with operating microscope or telescope | 090 | Cord injection — vocal cord medialization |
| 31546 | Laryngoscopy, direct; with vocal cord injection, with operating microscope or telescope, with computer-assisted planning | 090 | With navigation |
| 31551 | Laryngoplasty for laryngeal stenosis; with graft, without indwelling stent placement | 090 | Laryngeal reconstruction |
| 31552 | Laryngoplasty for laryngeal stenosis; with graft, with indwelling stent placement | 090 | With stent |
| 31553 | Laryngoplasty for laryngeal stenosis; with graft, without indwelling stent placement, age 12 and under | 090 | Pediatric |
| 31554 | Laryngoplasty for laryngeal stenosis; with graft, with indwelling stent placement, age 12 and under | 090 | Pediatric with stent |
| 31560 | Laryngoscopy, direct; with arytenoidectomy | 090 | Arytenoid removal — bilateral cord paralysis |
| 31561 | Laryngoscopy, direct; with arytenoidectomy, with operating microscope or telescope | 090 | Micro-arytenoidectomy |
| 31571 | Laryngoscopy, direct, operative; with injection of inert material for unilateral vocal cord paralysis | 090 | Injection medialization |
| 31572 | Laryngoscopy, direct, operative; with ablation of laryngeal lesion using laser | 090 | Laser ablation — papilloma, tumor |
| 31573 | Laryngoscopy, flexible, therapeutic; with injection(s) for chemodenervation | 000 | In-office Botox vocal cord |
| 31574 | Laryngoscopy, flexible, therapeutic; with injection of inert material | 000 | In-office injection medialization |
| 31575 | Laryngoscopy, flexible; diagnostic | 000 | Flexible fiberoptic laryngoscopy — office |
| 31576 | Laryngoscopy, flexible; with biopsy | 000 | Flexible with biopsy |
| 31577 | Laryngoscopy, flexible; with removal of foreign body | 000 | Flexible with FB |
| 31578 | Laryngoscopy, flexible; with removal of lesion | 000 | Flexible with lesion |
| 31579 | Laryngoscopy, flexible or rigid telescopic; with stroboscopy | 000 | Videostroboscopy — voice evaluation |
Laryngectomy
| CPT | Description | Global | Notes |
|---|---|---|---|
| 31300 | Laryngotomy (thyrotomy, laryngofissure) | 090 | Open larynx — rare |
| 31360 | Laryngectomy; total, without radical neck dissection | 090 | Total laryngectomy, no RND |
| 31365 | Laryngectomy; total, with radical neck dissection | 090 | Total + radical neck |
| 31367 | Laryngectomy; subtotal supraglottic, without radical neck dissection | 090 | Supraglottic |
| 31368 | Laryngectomy; subtotal supraglottic, with radical neck dissection | 090 | Supraglottic + radical neck |
| 31370 | Partial laryngectomy (hemilaryngectomy); horizontal | 090 | Horizontal partial |
| 31375 | Partial laryngectomy; lateralizing cartilage resection | 090 | Lateralizing |
| 31380 | Partial laryngectomy; antero-lateral vertical partial | 090 | Frontolateral |
| 31382 | Partial laryngectomy; antero-lateral vertical partial, with radical neck dissection | 090 | With RND |
| 31390 | Pharyngolaryngectomy, with radical neck dissection; without reconstruction | 090 | Extensive resection |
| 31395 | Pharyngolaryngectomy, with radical neck dissection; with reconstruction | 090 | With free flap or reconstruction |
| 31611 | Construction of tracheoesophageal fistula and subsequent insertion of alaryngeal speech prosthesis | 090 | TEP — separately reportable from laryngectomy |
Trachea
| CPT | Description | Global | Notes |
|---|---|---|---|
| 31600 | Tracheostomy, planned (separate procedure) | 090 | Elective open tracheostomy |
| 31601 | Tracheostomy, planned; younger than 2 years | 090 | Pediatric tracheostomy |
| 31603 | Tracheostomy, emergency procedure; transtracheal | 010 | Emergency needle cricothyrotomy |
| 31605 | Tracheostomy, emergency procedure; cricothyroid membrane | 010 | Surgical cricothyrotomy |
| 31610 | Tracheostomy, fenestration procedure with skin flaps | 090 | Permanent tracheostomy with flaps |
| 31611 | Construction of tracheoesophageal fistula | 090 | TEP placement |
| 31612 | Tracheal puncture, percutaneous with transtracheal aspiration and/or injection | 000 | Percutaneous aspiration |
| 31613 | Tracheostoma revision; simple, without flap rotation | 090 | Stoma revision |
| 31614 | Tracheostoma revision; complex, with flap rotation | 090 | Complex stoma revision |
| 31615 | Tracheobronchoscopy through established tracheostomy incision | 000 | Scope through stoma |
| 31622 | Bronchoscopy, rigid or flexible, including fluoroscopic guidance when performed; diagnostic | 000 | Diagnostic bronchoscopy |
| 31625 | Bronchoscopy; with biopsy | 000 | Bronchoscopy with tissue |
Pharynx and Adenoids
| CPT | Description | Global | Notes |
|---|---|---|---|
| 42700 | Incision and drainage of peritonsillar abscess | 010 | PTA I&D — office or ED |
| 42720 | Incision and drainage of retropharyngeal abscess; intraoral approach | 090 | Retropharyngeal abscess |
| 42725 | Incision and drainage of retropharyngeal abscess; external approach | 090 | External approach |
| 42800 | Biopsy, oropharynx | 000 | Oropharyngeal tissue biopsy |
| 42808 | Excision or destruction of lesion of pharynx | 010 | Pharyngeal lesion |
| 42809 | Removal of foreign body from pharynx | 000 | FB removal |
| 42810 | Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues | 090 | Superficial branchial cleft |
| 42815 | Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx | 090 | Deep branchial cleft |
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 090 | T&A, pediatric |
| 42821 | Tonsillectomy and adenoidectomy; age 12 and over | 090 | T&A, adult |
| 42830 | Adenoidectomy, primary; younger than age 12 | 090 | Adenoids only, pediatric |
| 42831 | Adenoidectomy, primary; age 12 and over | 090 | Adenoids only, adult |
| 42835 | Adenoidectomy, secondary; younger than age 12 | 090 | Revision adenoidectomy, pediatric |
| 42836 | Adenoidectomy, secondary; age 12 and over | 090 | Revision adenoidectomy, adult |
| 42870 | Excision or destruction of lingual tonsil, any method | 090 | Lingual tonsil — OSA/tongue base reduction |
| 42890 | Limited pharyngectomy | 090 | Partial pharynx removal |
| 42892 | Resection of lateral pharyngeal wall, direct | 090 | Lateral wall |
| 42894 | Resection of pharyngeal wall, radical | 090 | Radical pharyngeal resection |
| 42950 | Pharyngoplasty | 090 | Pharynx reconstruction |
| 42953 | Pharyngoesophageal repair | 090 | Combined pharynx/esophagus |
| 42960 | Control of nasopharyngeal hemorrhage; simple | 010 | Post-tonsillectomy bleed — simple |
| 42961 | Control of nasopharyngeal hemorrhage; requiring hospitalization | 010 | Post-tonsillectomy bleed — admission |
| 42962 | Control of nasopharyngeal hemorrhage; with secondary surgical intervention | 010 | Return to OR — modifier -78 |
| 42970 | Control of nasopharyngeal hemorrhage, posterior, with posterior nasal packs and/or cautery | 010 | Posterior hemorrhage control |
Tonsils
Tonsillectomy Age-Based Code Selection:
| CPT | Description | Global | Notes |
|---|---|---|---|
| 42820 | Tonsillectomy and adenoidectomy; younger than age 12 | 090 | Most commonly billed pediatric ENT procedure |
| 42821 | Tonsillectomy and adenoidectomy; age 12 and over | 090 | Adult T&A |
| 42825 | Tonsillectomy, primary or secondary; younger than age 12 | 090 | Tonsils only, pediatric |
| 42826 | Tonsillectomy, primary or secondary; age 12 and over | 090 | Tonsils only, adult |
| 42830 | Adenoidectomy, primary; younger than age 12 | 090 | Adenoids only, pediatric |
| 42831 | Adenoidectomy, primary; age 12 and over | 090 | Adenoids only, adult |
| 42870 | Excision or destruction of lingual tonsil | 090 | Tongue base — bundled with 42820/42826 in same session per CMS |
Salivary Glands
| CPT | Description | Global | Notes |
|---|---|---|---|
| 42300 | Drainage of abscess; parotid, simple | 010 | Parotid abscess |
| 42305 | Drainage of abscess; parotid, complicated | 090 | Complex parotid abscess |
| 42310 | Drainage of abscess; submaxillary or sublingual, intraoral | 010 | Submandibular abscess, intraoral |
| 42320 | Drainage of abscess; submaxillary, external | 010 | External submandibular |
| 42340 | Drainage of abscess; parotid, external complicated | 090 | External complex parotid |
| 42400 | Biopsy of salivary gland; needle, percutaneous | 000 | FNA or core biopsy |
| 42405 | Biopsy of salivary gland; incisional | 010 | Open incisional biopsy |
| 42408 | Excision of sublingual salivary cyst (ranula) | 090 | Ranula excision |
| 42409 | Marsupialization of sublingual salivary cyst (ranula) | 090 | Ranula marsupialization |
| 42410 | Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection | 090 | Superficial parotidectomy |
| 42415 | Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve | 090 | Superficial parotidectomy with facial nerve preservation |
| 42420 | Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve | 090 | Total parotidectomy, nerve preservation |
| 42425 | Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve | 090 | Total parotidectomy, nerve sacrifice |
| 42426 | Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection | 090 | Total parotidectomy + RND |
| 42440 | Excision of submandibular (submaxillary) gland | 090 | Submandibular gland excision |
| 42450 | Excision of sublingual gland | 090 | Sublingual gland excision |
| 42500 | Plastic repair of salivary duct, sialodochoplasty; primary or simple | 090 | Duct repair |
| 42505 | Plastic repair of salivary duct; secondary or complicated | 090 | Complex duct repair |
| 42507 | Parotid duct diversion, bilateral (Wilke procedure) | 090 | For sialorrhea — drooling |
| 42508 | Parotid duct diversion, bilateral, with excision of one or both submandibular glands | 090 | Drooling surgery |
| 42509 | Parotid duct diversion, bilateral, with relocation of submandibular ducts | 090 | Full diversion |
| 42510 | Parotid duct diversion, bilateral, with relocation of submandibular ducts and excision of one or both glands | 090 | Complete diversion with excision |
| 42550 | Injection procedure for sialography | 000 | Salivary duct contrast study |
| 42600 | Closure of salivary fistula | 090 | Fistula repair |
| 42650 | Dilation of salivary duct | 000 | Office dilation |
| 42660 | Dilation and catheterization of salivary duct, with or without injection | 000 | Catheterization |
| 42665 | Ligation of salivary duct; intraoral | 010 | Duct ligation |
| 42699 | Unlisted procedure, salivary glands or ducts | N/A | Unlisted salivary |
Mouth and Oral Cavity
| CPT | Description | Global | Notes |
|---|---|---|---|
| 40490 | Biopsy of lip | 000 | Lip lesion biopsy |
| 40510 | Excision of lip; transverse wedge excision with primary closure | 090 | Wedge lip excision |
| 40520 | Excision of lip; V-excision with primary direct linear closure | 090 | V-excision |
| 40525 | Excision of lip; full thickness, reconstruction with local flap | 090 | Abbe flap, etc. |
| 40530 | Excision of lip; full thickness, reconstruction with cross lip flap (Abbé-Estlander) | 090 | Cross lip flap |
| 40700 | Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral | 090 | Unilateral cleft lip |
| 40701 | Plastic repair of cleft lip/nasal deformity; primary bilateral, one stage | 090 | Bilateral cleft lip, one stage |
| 40702 | Plastic repair of cleft lip/nasal deformity; primary bilateral, second stage | 090 | Bilateral cleft lip, stage 2 |
| 40720 | Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure | 090 | Secondary revision |
| 41000 | Intraoral incision and drainage of abscess, cyst, or hematoma of tongue | 010 | Tongue I&D |
| 41005 | Intraoral incision and drainage of abscess, cyst, or hematoma; sublingual, superficial | 010 | Sublingual I&D |
| 41010 | Incision of lingual frenum (frenotomy) | 000 | Tongue tie release |
| 41115 | Excision of lingual frenum (frenectomy) | 010 | Tongue tie excision |
| 41520 | Frenoplasty | 090 | Frenulum reconstruction |
Head and Neck — Excision and Neck Dissection
Neck Dissection
| CPT | Description | Global | Notes |
|---|---|---|---|
| 38700 | Suprahyoid neck dissection | 090 | Level I only |
| 38720 | Cervical lymphadenectomy (modified radical neck dissection) | 090 | Selective/modified radical neck dissection |
| 38724 | Cervical lymphadenectomy (radical neck dissection) | 090 | Radical neck dissection — removes SCM, IJV, CN XI |
| 38740 | Axillary lymphadenectomy; superficial | 090 | Superficial axillary LND |
| 38745 | Axillary lymphadenectomy; complete | 090 | Complete axillary LND |
Sentinel Lymph Node Biopsy
| CPT | Description | Notes |
|---|---|---|
| 38500 | Biopsy or excision of lymph node(s); open, superficial | Office or OR lymph node excision |
| 38505 | Biopsy or excision of lymph node(s); by needle, superficial | FNA or core biopsy, lymph node |
| 38510 | Biopsy or excision of lymph node(s); open, deep, cervical node(s) | Deep cervical node |
| 38525 | Biopsy or excision of lymph node(s); open, deep, axillary node(s) | Deep axillary node |
| 38792 | Injection procedure; radioactive tracer for identification of sentinel node | Lymphoscintigraphy injection |
| 38900 | Intraoperative identification (including injection of dye) of sentinel lymph node | Gamma probe/blue dye — add-on |
Thyroid and Parathyroid (often ENT-performed)
| CPT | Description | Global | Notes |
|---|---|---|---|
| 60100 | Biopsy thyroid, percutaneous core needle | 000 | Core biopsy — not FNA |
| 60200 | Excision of cyst or adenoma of thyroid | 090 | Partial thyroid excision |
| 60210 | Partial thyroid lobectomy, unilateral; without contralateral subtotal lobectomy | 090 | Partial lobectomy |
| 60212 | Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy | 090 | Bilateral partial |
| 60220 | Total thyroid lobectomy, unilateral; without contralateral subtotal lobectomy | 090 | Hemithyroidectomy |
| 60225 | Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy | 090 | Near-total thyroidectomy |
| 60240 | Thyroidectomy, total or complete | 090 | Total thyroidectomy |
| 60252 | Thyroidectomy, total or subtotal for malignancy; with limited neck dissection | 090 | Total + limited central neck |
| 60254 | Thyroidectomy, total or subtotal for malignancy; with radical neck dissection | 090 | Total + radical neck |
| 60260 | Thyroidectomy, removal of all remaining thyroid tissue after prior partial thyroidectomy | 090 | Completion thyroidectomy |
| 60270 | Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach | 090 | Substernal goiter |
| 60271 | Thyroidectomy, including substernal thyroid; cervical approach | 090 | Substernal via cervical |
| 60500 | Parathyroidectomy or exploration of parathyroid gland(s) | 090 | Parathyroid exploration |
| 60502 | Parathyroidectomy or exploration; re-exploration | 090 | Revision parathyroid |
| 60505 | Parathyroidectomy or exploration; with mediastinal exploration, sternal split or transthoracic approach | 090 | Mediastinal parathyroid |
| 60512 | Parathyroid autotransplantation | 090 | Add-on — parathyroid reimplantation |
| 60520 | Thymectomy; partial or total; transcervical approach | 090 | Cervical thymectomy |
| 60521 | Thymectomy; partial or total; sternal split approach | 090 | Sternal approach |
| 60522 | Thymectomy; partial or total; combined transcervical and sternal approach | 090 | Combined approach |
MS-DRG Reference
MDC 03 — Diseases and Disorders of the Ear, Nose, Mouth and Throat
| DRG | Description | When |
|---|---|---|
| 129 | Major Head and Neck Procedures with MCC | Major resection, LND, laryngectomy with MCC |
| 130 | Major Head and Neck Procedures with CC | Major procedures with CC |
| 131 | Major Head and Neck Procedures without CC/MCC | Major procedures, no CC/MCC |
| 132 | Laryngeal and Other ENT OR Procedures with MCC | ENT OR procedures, MCC |
| 133 | Laryngeal and Other ENT OR Procedures with CC | ENT OR procedures, CC |
| 134 | Laryngeal and Other ENT OR Procedures without CC/MCC | ENT OR procedures, no CC/MCC |
| 135 | Sinus and Mastoid Procedures with MCC | Sinus/mastoid surgery, MCC |
| 136 | Sinus and Mastoid Procedures with CC | Sinus/mastoid surgery, CC |
| 137 | Sinus and Mastoid Procedures without CC/MCC | Sinus/mastoid surgery, no CC/MCC |
| 138 | Mouth Procedures with MCC | Oral procedures, MCC |
| 139 | Mouth Procedures with CC | Oral procedures, CC |
| 140 | Mouth Procedures without CC/MCC | Oral, no CC/MCC |
| 141 | Salivary Gland Procedures | Salivary gland surgery |
| 185 | Dental and Oral Disease with MCC | MDC 03 medical, MCC |
| 186 | Dental and Oral Disease with CC | MDC 03 medical, CC |
| 187 | Dental and Oral Disease without CC/MCC | MDC 03 medical, no CC/MCC |
Global Period Quick Reference
| Global Period | Examples in ENT |
|---|---|
| 000 | Flexible laryngoscopy (31575), cerumen removal (69210), diagnostic endoscopy (31231), biopsy (30100) |
| 010 | Tube insertion (69436), simple tympanoplasty (69610), turbinate reduction (30130/30140), epistaxis (30901/30905) |
| 090 | Tonsillectomy (42820/42826), septoplasty (30520), FESS (31254-31298), laryngectomy (31360/31365), parotidectomy (42415), tympanoplasty (69631-69646) |
| XXX | Diagnostic procedures only; no global |
Common ICD-10-CM Diagnoses — ENT
Ear
| ICD-10-CM | Description |
|---|---|
| H61.23 | Impacted cerumen, bilateral |
| H66.003 | Acute suppurative otitis media, bilateral |
| H65.23 | Chronic serous otitis media, bilateral |
| H69.83 | Other specified disorders of Eustachian tube, bilateral |
| H72.01 | Central perforation of tympanic membrane, right |
| H74.31 | Acquired abnormality of ossicular chain, right |
| H80.03 | Cochlear otosclerosis, bilateral |
| H91.03 | Ototoxic hearing loss, bilateral |
| H90.3 | Sensorineural hearing loss, bilateral |
| H83.01 | Labyrinthitis, right ear |
| H81.01 | Meniere’s disease, right ear |
Nose and Sinuses
| ICD-10-CM | Description |
|---|---|
| J34.2 | Deviated nasal septum |
| J34.3 | Hypertrophy of nasal turbinates |
| J32.0 | Chronic maxillary sinusitis |
| J32.2 | Chronic ethmoidal sinusitis |
| J32.3 | Chronic sphenoidal sinusitis |
| J32.1 | Chronic frontal sinusitis |
| J32.4 | Chronic pansinusitis |
| J33.0 | Polyp of nasal cavity |
| J33.8 | Other polyp of sinus |
| R04.0 | Epistaxis |
| J30.1 | Allergic rhinitis due to pollen |
| J30.9 | Allergic rhinitis, unspecified |
Throat and Tonsils
| ICD-10-CM | Description |
|---|---|
| J35.01 | Chronic tonsillitis |
| J35.03 | Chronic tonsillitis and adenoiditis |
| J36 | Peritonsillar abscess |
| J35.1 | Hypertrophy of tonsils |
| J35.2 | Hypertrophy of adenoids |
| J35.3 | Hypertrophy of tonsils with hypertrophy of adenoids |
| G47.33 | Obstructive sleep apnea, pediatric |
| G47.33 | Obstructive sleep apnea |
Larynx and Voice
| ICD-10-CM | Description |
|---|---|
| J38.0 | Paralysis of vocal cords and larynx |
| J38.01 | Paralysis of vocal cords and larynx, unilateral |
| J38.02 | Paralysis of vocal cords and larynx, bilateral |
| J38.1 | Polyp of vocal cord and larynx |
| J38.2 | Nodules of vocal cords |
| J38.3 | Other diseases of vocal cords |
| J38.4 | Edema of larynx |
| J38.5 | Laryngeal spasm |
| J38.6 | Stenosis of larynx |
| J38.7 | Other diseases of larynx |
| C32.0 | Malignant neoplasm of glottis |
| C32.1 | Malignant neoplasm of supraglottis |
Head and Neck Malignancy
| ICD-10-CM | Description |
|---|---|
| C09.9 | Malignant neoplasm of tonsil, unspecified |
| C10.9 | Malignant neoplasm of oropharynx, unspecified |
| C11.9 | Malignant neoplasm of nasopharynx, unspecified |
| C13.9 | Malignant neoplasm of hypopharynx, unspecified |
| C32.0 | Malignant neoplasm of glottis |
| C32.1 | Malignant neoplasm of supraglottis |
| C73 | Malignant neoplasm of thyroid gland |
| C77.0 | Secondary malignant neoplasm of lymph nodes of head, face and neck |
| D11.0 | Benign neoplasm of parotid gland |
Modifier Quick Reference — ENT
| Modifier | ENT Use Case |
|---|---|
| -25 | Same-day E/M with procedure — cerumen removal + ETD management; endoscopy + new patient eval |
| -50 | Bilateral procedure — bilateral tubes, bilateral FESS, bilateral turbinate reduction |
| -51 | Multiple procedures same session — septoplasty + turbinates; FESS + septoplasty |
| -52 | Reduced services — unilateral when bilateral planned; incomplete FESS |
| -53 | Discontinued procedure — patient safety reason; unable to complete |
| -58 | Staged procedure — planned second-stage sinus surgery |
| -59 | Distinct procedural service — unbundle separately payable procedures |
| -62 | Co-surgeons — skull base; free flap reconstruction requiring two primaries |
| -78 | Unplanned return to OR in global period — post-tonsillectomy hemorrhage |
| -79 | Unrelated procedure in global period |
| -LT/-RT | Laterality — required for all unilateral ear, nasal, sinus, and neck procedures |
| -22 | Significantly increased complexity — hostile anatomy, revision surgery, extended LND |
| -XU | Unusual non-overlapping service — alternative to -59 |
Individual Code Notes in This Vault
| CPT | Description | Note Status |
|---|---|---|
| 42820 | Tonsillectomy and adenoidectomy, under 12 | ✅ |
| 42826 | Tonsillectomy, age 12 and over | ✅ |
| 30520 | Septoplasty | ✅ |
| 30140 | Submucous resection inferior turbinate | ✅ |
| 31267 | FESS maxillary antrostomy with tissue removal | ✅ |
| 31255 | FESS total ethmoidectomy | ✅ |
| 69436 | Tympanostomy, general anesthesia | ✅ |
| 69631 | Tympanoplasty with ossicular chain reconstruction | ✅ |
| 31360 | Total laryngectomy | ✅ |
| 42415 | Superficial parotidectomy with facial nerve preservation | ✅ |
| 60240 | Total thyroidectomy | ✅ |
| 38720 | Cervical lymphadenectomy | ✅ |
| 30905 | Posterior epistaxis control | ✅ |
| 69210 | Removal of impacted cerumen | ✅ |
Suggested Obsidian Linkouts
- Otolaryngology Practice Coding Scenarios
- Global Surgical Package MOC
- Procedure Status & Complexity Modifiers
- Urology CPT Codes Reference
- H20 Iridocyclitis Family MOC
- -25 - Modifier 25
- -50 - Modifier 50, bilateral procedures
- -51 - Modifier 51, multiple procedures
- -53 - Modifier 53, discontinued procedure
- -58 - Modifier 58, staged procedure
- -62 - Modifier 62, co-surgeons
- -78 - Modifier 78, unplanned return to OR
- -RT - Laterality modifiers
- -22 - Modifier 22, increased procedural services