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

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 Vermont, Medicare pays $153.38 for 92601 in the office and $97.82 when it’s performed in a hospital or facility.

$153.38Office (non-facility)
$97.82Hospital or facility
−0.6%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 Vermont
  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 Vermont 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. Vermont pays $153.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

92601 in Vermont vs other payment areas
  1. Vermont · this page$153.38
  2. Los Angeles, CA · California$171.47+$18.09
  3. Washington, DC area · District of Columbia$172.23+$18.85
  4. Miami, FL · Florida$157.99+$4.61
  5. Chicago, IL · Illinois$155.67+$2.29
  6. Manhattan, NY · New York$171.92+$18.54
  7. Alaska · Alaska$197.59+$44.21

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

Every other payment area

92601 in every other Medicare payment locality
Payment localityOfficeFacility
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

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 92601 in Vermont
ComponentRVULocality factorAdjusted
Physician work2.30× 1.0002.3000
Practice expense2.31× 0.9902.2869
Malpractice0.01× 0.5060.0051
Total RVUs4.5920
Conversion factor× 33.4009

Office rate, Vermont$153.38

Office: (2.3 × 1 + 2.31 × 0.99 + 0.01 × 0.506) × $33.4009 = $153.38

Facility: (2.3 × 1 + 0.63 × 0.99 + 0.01 × 0.506) × $33.4009 = $97.82

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, Vermont
Same family
92602Implant reprogramming, subsequent, under age 7Subsequent cochlear implant reprogramming for a patient younger than 7.$96.50
92603Implant analysis, age seven or olderDiagnostic analysis with programming for a patient age 7 or older.$144.76
92604Cochlear implant programming, age 7 or olderSubsequent cochlear implant reprogramming for a patient age 7 or older.$86.89

How 92601 has changed in Vermont

92601 · Office / nonfacility

$153.38

Effective 2026-10-01

The base rate is $2.34 higher than on 2025-10-01, moving from $151.04 to $153.38 (1.5%).

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

    $151.04changed to$153.38

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $155.93changed to$151.04

    • 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

    $153.39changed to$155.93

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $161.48changed to$153.39

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.44 changed to 2.37
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $165.54changed to$161.48

    • 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
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $169.01changed to$165.54

    • 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

    $170.02changed to$169.01

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.34 changed to 2.49
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $168.74changed to$170.02

    • 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
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $168.55changed to$168.74

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $149.59changed to$168.55

    • 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 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $141.85changed to$149.59

    • 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 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $137.80changed to$141.85

    • 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

    $137.11changed to$137.80

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $139.61changed to$137.11

    • 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
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$139.61

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$153.38$97.82RVU26D
2026-07-01$153.38$97.82RVU26C
2026-04-01$153.38$97.82RVU26B
2026-01-01$153.38$97.82RVU26A
2025-10-01$151.04$116.67RVU25D
2025-07-01$151.04$116.67RVU25C
2025-04-01$151.04$116.67RVU25B
2025-01-01$151.04$116.67RVU25A
2024-10-01$155.93$119.24RVU24D
2024-07-01$155.93$119.24RVU24C
2024-04-01$155.93$119.24RVU24B
2024-03-09$155.93$119.24RVU24AR
2024-01-01$153.39$117.30RVU24A
2023-10-01$161.48$121.95RVU23D
2023-07-01$161.48$121.95RVU23C
2023-04-01$161.48$121.95RVU23B
2023-01-01$161.48$121.95RVU23A
2022-10-01$165.54$124.32RVU22D
2022-07-01$165.54$124.32RVU22C
2022-04-01$165.54$124.32RVU22B
2022-01-01$165.54$124.32RVU22A
2021-10-01$169.01$125.35RVU21D
2021-07-01$169.01$125.35RVU21C
2021-04-01$169.01$125.35RVU21B
2021-01-01$169.01$125.35RVU21A
2020-10-01$170.02$128.55RVU20D
2020-07-01$170.02$128.55RVU20C
2020-04-01$170.02$128.55RVU20B
2020-01-01$170.02$128.55RVU20A
2019-10-01$168.74$128.14RVU19D
2019-07-01$168.74$128.14RVU19C
2019-04-01$168.74$128.14RVU19B
2019-01-01$168.74$128.14RVU19A
2018-10-01$168.55$128.36RVU18D
2018-07-01$168.55$128.36RVU18C
2018-04-01$168.55$128.36RVU18B
2018-01-01$168.55$128.36RVU18AR1
2017-10-01$149.59$122.76RVU17D
2017-07-01$149.59$122.76RVU17C
2017-04-01$149.59$122.76RVU17B
2017-01-01$149.59$122.76RVU17A
2016-10-01$141.85$120.28RVU16D
2016-07-01$141.85$120.28RVU16C
2016-04-01$141.85$120.28RVU16B
2016-01-01$141.85$120.28RVU16A
2015-10-01$137.80$118.32RVU15D
2015-07-01$137.80$118.32RVU15C
2015-04-01$137.11$117.73RVU15B
2015-01-01$137.11$117.73RVU15A
2014-10-01$139.61$120.14RVU14D
2014-07-01$139.61$120.14RVU14C
2014-04-01$139.61$120.14RVU14B
2014-01-01$139.61$120.14RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
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 Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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