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CPT code 92601: Cochlear implant, diagnostic analysis, under age 72026 Medicare rate & RVUs in Chicago, IL

Report cochlear implant diagnostic analysis with programming for a child younger than 7 when the audiologist evaluates implant function and adjusts processor settings.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Chicago, IL, Medicare pays $155.67 for 92601 in the office and $99.27 when it’s performed in a hospital or facility.

$155.67Office (non-facility)
$99.27Hospital or facility
+0.9%vs the national office rate ($154.31)

Check a contract rate as a % of Medicare · 92601 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 92601 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Chicago, IL
  2. What 92601 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 92601 covers

An audiologist uses this service to evaluate a cochlear implant and program the sound processor for a child younger than 7. The visit may include checking device function, assessing the child’s auditory responses, and adjusting the processor program, or map, based on the evaluation. It is used for pediatric cochlear implant management when diagnostic analysis and programming are performed, rather than for a programming-only visit.

Choose the code based on the patient’s age and the service performed: 92601 is for diagnostic analysis with programming under age 7; 92602 is for subsequent reprogramming in that age group. The record should support the diagnostic work and programming performed, including relevant findings and adjustments. CMS classifies this as a therapy service, so the professional component modifier 26 is not used.

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 Chicago, IL compares for 92601

Across 109 of 109 payment localities, the office rate for 92601 runs from $143.27 in Arkansas to $197.59 in Alaska. Chicago, IL pays $155.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

92601 in Chicago, IL vs other payment areas
  1. Chicago, IL · this page$155.67
  2. East St. Louis, IL · Illinois$148.48−$7.19
  3. Rest of Illinois · Illinois$147.79−$7.88
  4. Suburban Chicago, IL · Illinois$157.19+$1.52
  5. Los Angeles, CA · California$171.47+$15.80
  6. Washington, DC area · District of Columbia$172.23+$16.56
  7. Miami, FL · Florida$157.99+$2.32

Other areas in Illinois first, then benchmark localities. Bars start at $0.

Every other payment area

92601 in every other Medicare payment locality
Payment localityOfficeFacility
Manhattan, NYNew York$171.92$106.72
AlaskaAlaska$197.59$137.83
AlabamaAlabama$144.52$95.42
ArkansasArkansas$143.27$95.07
ArizonaArizona$151.87$97.50
Bakersfield, CACalifornia$163.05$101.55
Chico, CACalifornia$162.87$101.37
El Centro, CACalifornia$162.87$101.37

92601 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.

$143.27

$197.59

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

View every state and territory as a table
92601 office rate range by state
State / territoryOffice rate rangeLocalities
AK$197.591
AL$144.521
AR$143.271
AZ$151.871
CA$162.87–$196.7129
CO$160.101
CT$161.861
DC$172.231
DE$153.741
FL$151.09–$157.993
GA$146.04–$155.842
GU$164.741
HI$164.741
IA$147.551
ID$147.961
IL$147.79–$157.194
IN$148.511
KS$146.741
KY$145.721
LA$145.43–$149.812
MA$159.56–$172.392
MD$155.98–$172.233
ME$148.01–$153.492
MI$147.64–$151.842
MN$156.311
MO$143.66–$150.613
MS$143.501
MT$154.311
NC$149.021
ND$154.111
NE$148.161
NH$157.431
NJ$164.52–$171.522
NM$147.981
NV$154.331
NY$150.36–$174.105
OH$147.601
OK$145.981
OR$153.90–$164.022
PA$147.97–$158.922
PR$155.161
RI$158.281
SC$148.401
SD$154.091
TN$147.141
TX$147.34–$158.908
UT$149.651
VA$152.90–$172.232
VI$155.161
VT$153.381
WA$159.32–$175.612
WI$150.841
WV$144.351
WY$154.231

See 92601 in every payment locality

How the 92601 rate is calculated

Each of 92601’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 · 92601

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.30

2.30 RVUs× 1.000 GPCI

Practice expense2.31

2.31 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

4.6200

Conversion factor

$33.4009

Medicare rate

$154.31

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

The exact Chicago, IL inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,859

Code
92601
Physician work
2.30
Practice expense
2.31
Malpractice
0.01

GPCI2026.csv

48

Locality
Chicago, IL
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office calculation for 92601 in Chicago, IL
ComponentRVULocality factorAdjusted
Physician work2.30× 1.0072.3161
Practice expense2.31× 1.0052.3215
Malpractice0.01× 2.2950.0229
Total RVUs4.6606
Conversion factor× 33.4009

Office rate, Chicago, IL$155.67

Office: (2.3 × 1.007 + 2.31 × 1.005 + 0.01 × 2.295) × $33.4009 = $155.67

Facility: (2.3 × 1.007 + 0.63 × 1.005 + 0.01 × 2.295) × $33.4009 = $99.27

Open 92601 in the RVU calculator

Payment rules and modifiers for 92601

The CMS indicators that decide how 92601 is paid alongside other services.

CMS payment indicators · 92601

Cochlear implant, diagnostic analysis, under age 7

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
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/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

92601 without CQ · national office

$154.31

Cochlear implant, diagnostic analysis, under age 7

92601-CQ · Allowed amount unchanged

$154.31

Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.

Codes related to 92601

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

Codes related to 92601
CodeHow it relatesOffice range, Chicago, IL
Same family
92602Implant reprogramming, subsequent, under age 7Subsequent cochlear implant reprogramming for a patient younger than 7.$98.20
92603Implant analysis, age seven or olderDiagnostic analysis with programming for a patient age 7 or older.$146.94
92604Cochlear implant programming, age 7 or olderSubsequent cochlear implant reprogramming for a patient age 7 or older.$88.46

How 92601 has changed in Chicago, IL

92601 · Office / nonfacility

$155.67

Effective 2026-10-01

The base rate is $0.60 lower than on 2025-10-01, moving from $156.27 to $155.67 (0.4%).

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

    $156.27changed to$155.67

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.36 changed to 2.31
    • Malpractice RVU 0.05 changed to 0.01
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $161.83changed to$156.27

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.37 changed to 2.36
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $159.19changed to$161.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $168.01changed to$159.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.44 changed to 2.37
    • Work GPCI 1.009 changed to 1.007
    • Practice expense GPCI 1.033 changed to 1.023
    • Malpractice GPCI 1.945 changed to 2.018

  5. January 1, 2023

    RVU23A

    $174.09changed to$168.01

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.43 changed to 2.44
    • Malpractice RVU 0.09 changed to 0.06
    • Work GPCI 1.011 changed to 1.009
    • Practice expense GPCI 1.044 changed to 1.033
    • Malpractice GPCI 1.871 changed to 1.945

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $177.72changed to$174.09

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.49 changed to 2.43

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $177.66changed to$177.72

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.34 changed to 2.49
    • Work GPCI 1.009 changed to 1.011
    • Practice expense GPCI 1.039 changed to 1.044
    • Malpractice GPCI 1.898 changed to 1.871

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $174.81changed to$177.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.30 changed to 2.34
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.008 changed to 1.009
    • Practice expense GPCI 1.034 changed to 1.039
    • Malpractice GPCI 1.925 changed to 1.898

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $174.62changed to$174.81

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $157.50changed to$174.62

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.78 changed to 2.30
    • Malpractice RVU 0.11 changed to 0.08
    • Work GPCI 1.012 changed to 1.008
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 1.972 changed to 1.925

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $151.71changed to$157.50

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.56 changed to 1.78
    • Malpractice RVU 0.14 changed to 0.11
    • Work GPCI 1.016 changed to 1.012
    • Practice expense GPCI 1.037 changed to 1.036
    • Malpractice GPCI 2.019 changed to 1.972

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $148.49changed to$151.71

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.42 changed to 1.56
    • Malpractice RVU 0.16 changed to 0.14

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $147.75changed to$148.49

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $149.20changed to$147.75

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.52 changed to 1.42
    • Malpractice RVU 0.11 changed to 0.16
    • Work GPCI 1.023 changed to 1.016
    • Practice expense GPCI 1.044 changed to 1.037
    • Malpractice GPCI 2.048 changed to 2.019

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $141.65changed to$149.20

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.49 changed to 1.52
    • Work GPCI 1.030 changed to 1.023
    • Practice expense GPCI 1.051 changed to 1.044
    • Malpractice GPCI 2.077 changed to 2.048

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$141.65

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$155.67$99.27RVU26D
2026-07-01$155.67$99.27RVU26C
2026-04-01$155.67$99.27RVU26B
2026-01-01$155.67$99.27RVU26A
2025-10-01$156.27$120.87RVU25D
2025-07-01$156.27$120.87RVU25C
2025-04-01$156.27$120.87RVU25B
2025-01-01$156.27$120.87RVU25A
2024-10-01$161.83$124.03RVU24D
2024-07-01$161.83$124.03RVU24C
2024-04-01$161.83$124.03RVU24B
2024-03-09$161.83$124.03RVU24AR
2024-01-01$159.19$122.01RVU24A
2023-10-01$168.01$127.05RVU23D
2023-07-01$168.01$127.05RVU23C
2023-04-01$168.01$127.05RVU23B
2023-01-01$168.01$127.05RVU23A
2022-10-01$174.09$131.10RVU22D
2022-07-01$174.09$131.10RVU22C
2022-04-01$174.09$131.10RVU22B
2022-01-01$174.09$131.10RVU22A
2021-10-01$177.72$132.18RVU21D
2021-07-01$177.72$132.18RVU21C
2021-04-01$177.72$132.18RVU21B
2021-01-01$177.72$132.18RVU21A
2020-10-01$177.66$134.91RVU20D
2020-07-01$177.66$134.91RVU20C
2020-04-01$177.66$134.91RVU20B
2020-01-01$177.66$134.91RVU20A
2019-10-01$174.81$133.45RVU19D
2019-07-01$174.81$133.45RVU19C
2019-04-01$174.81$133.45RVU19B
2019-01-01$174.81$133.45RVU19A
2018-10-01$174.62$133.67RVU18D
2018-07-01$174.62$133.67RVU18C
2018-04-01$174.62$133.67RVU18B
2018-01-01$174.62$133.67RVU18AR1
2017-10-01$157.50$129.99RVU17D
2017-07-01$157.50$129.99RVU17C
2017-04-01$157.50$129.99RVU17B
2017-01-01$157.50$129.99RVU17A
2016-10-01$151.71$129.43RVU16D
2016-07-01$151.71$129.43RVU16C
2016-04-01$151.71$129.43RVU16B
2016-01-01$151.71$129.43RVU16A
2015-10-01$148.49$128.37RVU15D
2015-07-01$148.49$128.37RVU15C
2015-04-01$147.75$127.73RVU15B
2015-01-01$147.75$127.73RVU15A
2014-10-01$149.20$129.01RVU14D
2014-07-01$149.20$129.01RVU14C
2014-04-01$149.20$129.01RVU14B
2014-01-01$149.20$129.01RVU14A
2013-10-01$141.65$121.63RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 92601 for an earlier date of service

Where the Chicago, IL rate applies

Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Illinois

92601 billing questions

When should 92601 be selected instead of 92602?

Use 92601 when the encounter includes diagnostic analysis of the cochlear implant with programming for a child younger than 7. Use 92602 for subsequent reprogramming without that diagnostic analysis service.

How does 92601 differ from 92603?

Both describe diagnostic analysis with programming, but 92601 is for a patient younger than 7 and 92603 is for a patient age 7 or older.

Can modifier 26 be appended to 92601?

No. CMS classifies 92601 as a therapy service, for which the professional component modifier does not apply.

What documentation supports reporting 92601?

Document the cochlear implant assessment, relevant device or auditory findings, and the programming performed. The record should support diagnostic analysis, not programming alone.

Is 92601 a time-based code?

The code is distinguished by the diagnostic analysis and programming service and the patient’s age, not by a time increment in its descriptor.

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 92601PPRRVU2026_Oct_nonQPP.csv, line 11,859 (RVU26D)
Geographic factors for Chicago, ILGPCI2026.csv, line 48 (RVU26D)

Open CMS sourceHow we calculate rates

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