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

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 Manhattan, NY, Medicare pays $171.92 for 92601 in the office and $106.72 when it’s performed in a hospital or facility.

$171.92Office (non-facility)
$106.72Hospital or facility
+11.4%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 Manhattan, NY
  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 Manhattan, NY 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. Manhattan, NY pays $171.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

92601 in Manhattan, NY vs other payment areas
  1. Manhattan, NY · this page$171.92
  2. NYC suburbs and Long Island, NY · New York$174.10+$2.18
  3. Queens, NY · New York$173.42+$1.50
  4. Rest of New York · New York$150.36−$21.56
  5. Los Angeles, CA · California$171.47−$0.45
  6. Washington, DC area · District of Columbia$172.23+$0.31

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

Every other payment area

92601 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$157.99$99.57
Chicago, ILIllinois$155.67$99.27
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

92601 rates by state

Office rate range in each state. Select a state to see its payment localities.

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 Manhattan, NY 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

78

Locality
Manhattan, NY
Physician work
1.064
Practice expense
1.162
Malpractice
1.586
Office calculation for 92601 in Manhattan, NY
ComponentRVULocality factorAdjusted
Physician work2.30× 1.0642.4472
Practice expense2.31× 1.1622.6842
Malpractice0.01× 1.5860.0159
Total RVUs5.1473
Conversion factor× 33.4009

Office rate, Manhattan, NY$171.92

Office: (2.3 × 1.064 + 2.31 × 1.162 + 0.01 × 1.586) × $33.4009 = $171.92

Facility: (2.3 × 1.064 + 0.63 × 1.162 + 0.01 × 1.586) × $33.4009 = $106.72

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.

How 92601 has changed in Manhattan, NY

92601 · Office / nonfacility

$171.92

Effective 2026-10-01

The base rate is $1.00 higher than on 2025-10-01, moving from $170.92 to $171.92 (0.6%).

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

    $170.92changed to$171.92

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.166 changed to 1.162
    • Malpractice GPCI 1.656 changed to 1.586

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $176.83changed to$170.92

    • 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

    $173.95changed to$176.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $184.34changed to$173.95

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.44 changed to 2.37
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.184 changed to 1.166
    • Malpractice GPCI 1.843 changed to 1.656
  5. January 1, 2023

    RVU23A

    $191.54changed to$184.34

    • 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 1.056 changed to 1.061
    • Practice expense GPCI 1.203 changed to 1.184
    • Malpractice GPCI 2.031 changed to 1.843

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $195.65changed to$191.54

    • 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

    $194.07changed to$195.65

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.34 changed to 2.49
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.192 changed to 1.203
    • Malpractice GPCI 1.823 changed to 2.031

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $189.67changed to$194.07

    • 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 1.052 changed to 1.054
    • Practice expense GPCI 1.180 changed to 1.192
    • Malpractice GPCI 1.615 changed to 1.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $189.46changed to$189.67

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $168.51changed to$189.46

    • 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
    • Practice expense GPCI 1.174 changed to 1.180
    • Malpractice GPCI 1.690 changed to 1.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $160.71changed to$168.51

    • 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
    • Practice expense GPCI 1.168 changed to 1.174
    • Malpractice GPCI 1.764 changed to 1.690

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $156.68changed to$160.71

    • 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

    $155.90changed to$156.68

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $156.51changed to$155.90

    • 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 1.057 changed to 1.052
    • Practice expense GPCI 1.165 changed to 1.168
    • Malpractice GPCI 1.518 changed to 1.764

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $146.77changed to$156.51

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.49 changed to 1.52
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.162 changed to 1.165
    • Malpractice GPCI 1.271 changed to 1.518

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $146.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$171.92$106.72RVU26D
2026-07-01$171.92$106.72RVU26C
2026-04-01$171.92$106.72RVU26B
2026-01-01$171.92$106.72RVU26A
2025-10-01$170.92$130.56RVU25D
2025-07-01$170.92$130.56RVU25C
2025-04-01$170.92$130.56RVU25B
2025-01-01$170.92$130.56RVU25A
2024-10-01$176.83$133.75RVU24D
2024-07-01$176.83$133.75RVU24C
2024-04-01$176.83$133.75RVU24B
2024-03-09$176.83$133.75RVU24AR
2024-01-01$173.95$131.57RVU24A
2023-10-01$184.34$137.40RVU23D
2023-07-01$184.34$137.40RVU23C
2023-04-01$184.34$137.40RVU23B
2023-01-01$184.34$137.40RVU23A
2022-10-01$191.54$142.00RVU22D
2022-07-01$191.54$142.00RVU22C
2022-04-01$191.54$142.00RVU22B
2022-01-01$191.54$142.00RVU22A
2021-10-01$195.65$143.18RVU21D
2021-07-01$195.65$143.18RVU21C
2021-04-01$195.65$143.18RVU21B
2021-01-01$195.65$143.18RVU21A
2020-10-01$194.07$145.03RVU20D
2020-07-01$194.07$145.03RVU20C
2020-04-01$194.07$145.03RVU20B
2020-01-01$194.07$145.03RVU20A
2019-10-01$189.67$142.46RVU19D
2019-07-01$189.67$142.46RVU19C
2019-04-01$189.67$142.46RVU19B
2019-01-01$189.67$142.46RVU19A
2018-10-01$189.46$142.73RVU18D
2018-07-01$189.46$142.73RVU18C
2018-04-01$189.46$142.73RVU18B
2018-01-01$189.46$142.73RVU18AR1
2017-10-01$168.51$137.33RVU17D
2017-07-01$168.51$137.33RVU17C
2017-04-01$168.51$137.33RVU17B
2017-01-01$168.51$137.33RVU17A
2016-10-01$160.71$135.62RVU16D
2016-07-01$160.71$135.62RVU16C
2016-04-01$160.71$135.62RVU16B
2016-01-01$160.71$135.62RVU16A
2015-10-01$156.68$134.02RVU15D
2015-07-01$156.68$134.02RVU15C
2015-04-01$155.90$133.35RVU15B
2015-01-01$155.90$133.35RVU15A
2014-10-01$156.51$133.97RVU14D
2014-07-01$156.51$133.97RVU14C
2014-04-01$156.51$133.97RVU14B
2014-01-01$156.51$133.97RVU14A
2013-10-01$146.77$124.63RVU13D
2013-07-01$146.77$124.63RVU13C
2013-04-01$146.77$124.63RVU13B
2013-01-01$146.77$124.63RVU13AR

Price 92601 for an earlier date of service

Where the Manhattan, NY rate applies

Manhattan, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Manhattan, NYGPCI2026.csv, line 78 (RVU26D)

Open CMS sourceHow we calculate rates

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