CPT code 92601: Cochlear implant, diagnostic analysis, under age 72026 Medicare rate & RVUs in South Dakota
Report cochlear implant diagnostic analysis with programming for a child younger than 7 when the audiologist evaluates implant function and adjusts processor settings.
In South Dakota, Medicare pays $154.09 for 92601 in the office and $97.98 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $154.09. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$154.09
- Los Angeles, CA · California$171.47+$17.38
- Washington, DC area · District of Columbia$172.23+$18.14
- Miami, FL · Florida$157.99+$3.90
- Chicago, IL · Illinois$155.67+$1.58
- Manhattan, NY · New York$171.92+$17.83
- Alaska · Alaska$197.59+$43.50
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Fresno, CACalifornia | $162.87 | $101.37 |
| Hanford, CACalifornia | $162.87 | $101.37 |
| Madera, CACalifornia | $162.87 | $101.37 |
| Merced, CACalifornia | $162.87 | $101.37 |
| Modesto, CACalifornia | $162.87 | $101.37 |
| Napa, CACalifornia | $183.52 | $109.57 |
| Oxnard, CACalifornia | $170.38 | $104.05 |
| Redding, CACalifornia | $162.87 | $101.37 |
| Rest of CaliforniaCalifornia | $162.87 | $101.37 |
| Riverside, CACalifornia | $163.05 | $101.55 |
| Sacramento, CACalifornia | $169.50 | $104.24 |
| Salinas, CACalifornia | $168.81 | $103.77 |
| San Diego, CACalifornia | $171.59 | $104.47 |
| Marin County, CACalifornia | $193.06 | $113.94 |
| San Francisco, CACalifornia | $193.05 | $113.93 |
| San Benito County, CACalifornia | $196.71 | $115.79 |
| Santa Clara County, CACalifornia | $196.66 | $115.75 |
| San Luis Obispo, CACalifornia | $166.19 | $102.27 |
| Santa Cruz, CACalifornia | $172.36 | $104.18 |
| Santa Maria, CACalifornia | $169.12 | $103.69 |
| Santa Rosa, CACalifornia | $174.05 | $105.15 |
| Stockton, CACalifornia | $162.87 | $101.37 |
| Vallejo, CACalifornia | $183.51 | $109.55 |
| Visalia, CACalifornia | $162.87 | $101.37 |
| Yuba City, CACalifornia | $162.87 | $101.37 |
| ColoradoColorado | $160.10 | $100.39 |
| ConnecticutConnecticut | $161.86 | $101.43 |
| DelawareDelaware | $153.74 | $98.30 |
| Fort Lauderdale, FLFlorida | $155.59 | $98.74 |
| Rest of FloridaFlorida | $151.09 | $97.44 |
| Atlanta, GAGeorgia | $155.84 | $98.83 |
| Rest of GeorgiaGeorgia | $146.04 | $95.99 |
| Hawaii, Guam, HIHawaii | $164.74 | $100.94 |
| IowaIowa | $147.55 | $96.21 |
| IdahoIdaho | $147.96 | $96.34 |
| East St. Louis, ILIllinois | $148.48 | $96.85 |
| Rest of IllinoisIllinois | $147.79 | $96.56 |
| Suburban Chicago, ILIllinois | $157.19 | $99.56 |
| IndianaIndiana | $148.51 | $96.49 |
| KansasKansas | $146.74 | $96.01 |
| KentuckyKentucky | $145.72 | $95.83 |
| New Orleans, LALouisiana | $149.81 | $97.00 |
| Rest of LouisianaLouisiana | $145.43 | $95.76 |
| Metropolitan Boston, MAMassachusetts | $172.39 | $105.39 |
| Rest of MassachusettsMassachusetts | $159.56 | $100.48 |
| Baltimore area, MDMaryland | $161.25 | $101.04 |
| Rest of MarylandMaryland | $155.98 | $99.19 |
| Rest of MaineMaine | $148.01 | $96.39 |
| Southern Maine, MEMaine | $153.49 | $97.89 |
| Detroit, MIMichigan | $151.84 | $97.69 |
| Rest of MichiganMichigan | $147.64 | $96.41 |
| MinnesotaMinnesota | $156.31 | $98.57 |
| Metropolitan Kansas City, MOMissouri | $149.60 | $96.91 |
| Metropolitan St. Louis, MOMissouri | $150.61 | $97.19 |
| Rest of MissouriMissouri | $143.66 | $95.29 |
| MississippiMississippi | $143.50 | $95.19 |
| MontanaMontana | $154.31 | $98.20 |
| North CarolinaNorth Carolina | $149.02 | $96.67 |
| North DakotaNorth Dakota | $154.11 | $98.00 |
| NebraskaNebraska | $148.16 | $96.37 |
| New HampshireNew Hampshire | $157.43 | $99.02 |
| Northern New JerseyNew Jersey | $171.52 | $106.43 |
| Rest of New JerseyNew Jersey | $164.52 | $103.24 |
| New MexicoNew Mexico | $147.98 | $96.52 |
| NevadaNevada | $154.33 | $98.16 |
| NYC suburbs and Long Island, NYNew York | $174.10 | $107.38 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $165.17 | $103.72 |
| Queens, NYNew York | $173.42 | $107.09 |
| Rest of New YorkNew York | $150.36 | $97.05 |
| OhioOhio | $147.60 | $96.37 |
| OklahomaOklahoma | $145.98 | $95.87 |
| Portland, OROregon | $164.02 | $101.68 |
| Rest of OregonOregon | $153.90 | $98.02 |
| Metropolitan Philadelphia, PAPennsylvania | $158.92 | $100.51 |
| Rest of PennsylvaniaPennsylvania | $147.97 | $96.45 |
| Puerto RicoPuerto Rico | $155.16 | $98.43 |
| Rhode IslandRhode Island | $158.28 | $100.32 |
| South CarolinaSouth Carolina | $148.40 | $96.55 |
| TennesseeTennessee | $147.14 | $96.13 |
| Austin, TXTexas | $158.90 | $99.53 |
| Beaumont, TXTexas | $147.34 | $96.28 |
| Brazoria, TXTexas | $154.16 | $98.55 |
| Dallas, TXTexas | $154.65 | $98.76 |
| Fort Worth, TXTexas | $153.88 | $98.55 |
| Galveston, TXTexas | $154.33 | $98.61 |
| Houston, TXTexas | $154.51 | $98.79 |
| Rest of TexasTexas | $150.34 | $97.09 |
| UtahUtah | $149.65 | $96.90 |
| VirginiaVirginia | $152.90 | $97.74 |
| Virgin Islands, VIUnited States Virgin Islands | $155.16 | $98.43 |
| VermontVermont | $153.38 | $97.82 |
| Rest of WashingtonWashington | $159.32 | $100.23 |
| King County, WAWashington | $175.61 | $106.76 |
| WisconsinWisconsin | $150.84 | $97.08 |
| West VirginiaWest Virginia | $144.35 | $95.59 |
| WyomingWyoming | $154.23 | $98.11 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $197.59 | 1 |
| AL | $144.52 | 1 |
| AR | $143.27 | 1 |
| AZ | $151.87 | 1 |
| CA | $162.87–$196.71 | 29 |
| CO | $160.10 | 1 |
| CT | $161.86 | 1 |
| DC | $172.23 | 1 |
| DE | $153.74 | 1 |
| FL | $151.09–$157.99 | 3 |
| GA | $146.04–$155.84 | 2 |
| GU | $164.74 | 1 |
| HI | $164.74 | 1 |
| IA | $147.55 | 1 |
| ID | $147.96 | 1 |
| IL | $147.79–$157.19 | 4 |
| IN | $148.51 | 1 |
| KS | $146.74 | 1 |
| KY | $145.72 | 1 |
| LA | $145.43–$149.81 | 2 |
| MA | $159.56–$172.39 | 2 |
| MD | $155.98–$172.23 | 3 |
| ME | $148.01–$153.49 | 2 |
| MI | $147.64–$151.84 | 2 |
| MN | $156.31 | 1 |
| MO | $143.66–$150.61 | 3 |
| MS | $143.50 | 1 |
| MT | $154.31 | 1 |
| NC | $149.02 | 1 |
| ND | $154.11 | 1 |
| NE | $148.16 | 1 |
| NH | $157.43 | 1 |
| NJ | $164.52–$171.52 | 2 |
| NM | $147.98 | 1 |
| NV | $154.33 | 1 |
| NY | $150.36–$174.10 | 5 |
| OH | $147.60 | 1 |
| OK | $145.98 | 1 |
| OR | $153.90–$164.02 | 2 |
| PA | $147.97–$158.92 | 2 |
| PR | $155.16 | 1 |
| RI | $158.28 | 1 |
| SC | $148.40 | 1 |
| SD | $154.09 | 1 |
| TN | $147.14 | 1 |
| TX | $147.34–$158.90 | 8 |
| UT | $149.65 | 1 |
| VA | $152.90–$172.23 | 2 |
| VI | $155.16 | 1 |
| VT | $153.38 | 1 |
| WA | $159.32–$175.61 | 2 |
| WI | $150.84 | 1 |
| WV | $144.35 | 1 |
| WY | $154.23 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.30 | × 1.000 | 2.3000 |
| Practice expense | 2.31 | × 1.000 | 2.3100 |
| Malpractice | 0.01 | × 0.336 | 0.0034 |
| Total RVUs | 4.6134 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$154.09
Office: (2.3 × 1 + 2.31 × 1 + 0.01 × 0.336) × $33.4009 = $154.09
Facility: (2.3 × 1 + 0.63 × 1 + 0.01 × 0.336) × $33.4009 = $97.98
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy 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 South Dakota
92601 · Office / nonfacility
$154.09
Effective 2026-10-01
The base rate is $2.74 higher than on 2025-10-01, moving from $151.35 to $154.09 (1.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$151.35changed to$154.09
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$156.22changed to$151.35
- 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.
March 9, 2024
RVU24AR
$153.67changed to$156.22
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$161.37changed to$153.67
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.44 changed to 2.37
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$164.77changed to$161.37
- 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
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$168.23changed to$164.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.49 changed to 2.43
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$168.65changed to$168.23
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.34 changed to 2.49
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$166.90changed to$168.65
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$166.72changed to$166.90
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$147.99changed to$166.72
- 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
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$140.21changed to$147.99
- 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
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$135.97changed to$140.21
- 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.
July 1, 2015
RVU15C
$135.30changed to$135.97
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$138.48changed to$135.30
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$130.56changed to$138.48
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.49 changed to 1.52
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $130.56
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $154.09 | $97.98 | RVU26D |
| 2026-07-01 | $154.09 | $97.98 | RVU26C |
| 2026-04-01 | $154.09 | $97.98 | RVU26B |
| 2026-01-01 | $154.09 | $97.98 | RVU26A |
| 2025-10-01 | $151.35 | $116.74 | RVU25D |
| 2025-07-01 | $151.35 | $116.74 | RVU25C |
| 2025-04-01 | $151.35 | $116.74 | RVU25B |
| 2025-01-01 | $151.35 | $116.74 | RVU25A |
| 2024-10-01 | $156.22 | $119.27 | RVU24D |
| 2024-07-01 | $156.22 | $119.27 | RVU24C |
| 2024-04-01 | $156.22 | $119.27 | RVU24B |
| 2024-03-09 | $156.22 | $119.27 | RVU24AR |
| 2024-01-01 | $153.67 | $117.32 | RVU24A |
| 2023-10-01 | $161.37 | $121.72 | RVU23D |
| 2023-07-01 | $161.37 | $121.72 | RVU23C |
| 2023-04-01 | $161.37 | $121.72 | RVU23B |
| 2023-01-01 | $161.37 | $121.72 | RVU23A |
| 2022-10-01 | $164.77 | $123.59 | RVU22D |
| 2022-07-01 | $164.77 | $123.59 | RVU22C |
| 2022-04-01 | $164.77 | $123.59 | RVU22B |
| 2022-01-01 | $164.77 | $123.59 | RVU22A |
| 2021-10-01 | $168.23 | $124.61 | RVU21D |
| 2021-07-01 | $168.23 | $124.61 | RVU21C |
| 2021-04-01 | $168.23 | $124.61 | RVU21B |
| 2021-01-01 | $168.23 | $124.61 | RVU21A |
| 2020-10-01 | $168.65 | $127.51 | RVU20D |
| 2020-07-01 | $168.65 | $127.51 | RVU20C |
| 2020-04-01 | $168.65 | $127.51 | RVU20B |
| 2020-01-01 | $168.65 | $127.51 | RVU20A |
| 2019-10-01 | $166.90 | $126.90 | RVU19D |
| 2019-07-01 | $166.90 | $126.90 | RVU19C |
| 2019-04-01 | $166.90 | $126.90 | RVU19B |
| 2019-01-01 | $166.90 | $126.90 | RVU19A |
| 2018-10-01 | $166.72 | $127.12 | RVU18D |
| 2018-07-01 | $166.72 | $127.12 | RVU18C |
| 2018-04-01 | $166.72 | $127.12 | RVU18B |
| 2018-01-01 | $166.72 | $127.12 | RVU18AR1 |
| 2017-10-01 | $147.99 | $121.43 | RVU17D |
| 2017-07-01 | $147.99 | $121.43 | RVU17C |
| 2017-04-01 | $147.99 | $121.43 | RVU17B |
| 2017-01-01 | $147.99 | $121.43 | RVU17A |
| 2016-10-01 | $140.21 | $118.73 | RVU16D |
| 2016-07-01 | $140.21 | $118.73 | RVU16C |
| 2016-04-01 | $140.21 | $118.73 | RVU16B |
| 2016-01-01 | $140.21 | $118.73 | RVU16A |
| 2015-10-01 | $135.97 | $116.57 | RVU15D |
| 2015-07-01 | $135.97 | $116.57 | RVU15C |
| 2015-04-01 | $135.30 | $115.99 | RVU15B |
| 2015-01-01 | $135.30 | $115.99 | RVU15A |
| 2014-10-01 | $138.48 | $119.14 | RVU14D |
| 2014-07-01 | $138.48 | $119.14 | RVU14C |
| 2014-04-01 | $138.48 | $119.14 | RVU14B |
| 2014-01-01 | $138.48 | $119.14 | RVU14A |
| 2013-10-01 | $130.56 | $111.51 | RVU13D |
| 2013-07-01 | $130.56 | $111.51 | RVU13C |
| 2013-04-01 | $130.56 | $111.51 | RVU13B |
| 2013-01-01 | $130.56 | $111.51 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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