CPT code 92602: Implant reprogramming, subsequent, under age 72026 Medicare rate & RVUs in Missouri
Reports a follow-up session to adjust a cochlear implant’s programming for a patient younger than 7 after initial diagnostic analysis and programming.
Medicare pays $89.81–$94.63 for 92602 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 92602 covers
An audiologist typically reports this service when making subsequent programming adjustments to a cochlear implant for a child younger than 7. The visit may involve reviewing the child’s responses and changing processor map settings, such as stimulation levels, to support device use. It is for follow-up reprogramming, not the initial diagnostic analysis and programming session. The service may be furnished in an audiology office or another appropriate clinical setting.
Documentation should identify the patient’s age, cochlear implant, reason for the follow-up, programming changes made, and the child’s response or relevant findings. Select this code for a subsequent reprogramming session in a patient younger than 7; use the age-appropriate initial analysis code when the encounter is for initial diagnostic analysis and programming. CMS classifies the service as therapy, so the professional component modifier does not apply.
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.
Where 92602 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$89.81 to $94.63
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $93.93 | $55.04 |
| Metropolitan St. Louis, MO | $94.63 | $55.20 |
| Rest of Missouri | $89.81 | $54.11 |
How the 92602 rate is calculated
Each of 92602’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 · 92602
RVUs × geographic indexes × conversion factor
Work1.30
1.30 RVUs× 1.000 GPCI
Practice expense1.60
1.60 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
2.9100
Conversion factor
$33.4009
Medicare rate
$97.20
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92602
The CMS indicators that decide how 92602 is paid alongside other services.
CMS payment indicators · 92602
Implant reprogramming, subsequent, 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
92602 without CQ · national office
$97.20
Implant reprogramming, subsequent, under age 7
92602-CQ · Allowed amount unchanged
$97.20
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.
92602 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92601Cochlear implantDiagnostic analysis, under age 7
- Use 92601 for initial diagnostic analysis and programming in a patient younger than 7; use 92602 for a later reprogramming session.
- 92603Implant analysisAge seven or older
- 92603 is for initial diagnostic analysis and programming in patients age 7 or older. Code 92602 is for subsequent reprogramming in patients younger than 7.
- 92604Cochlear implant programmingAge 7 or older
- Both codes describe subsequent cochlear implant reprogramming; choose 92602 for a patient younger than 7 and 92604 for a patient age 7 or older.
92602 billing questions
How does 92602 differ from 92601?
92602 is for subsequent cochlear implant reprogramming in a patient younger than 7. Code 92601 describes the initial diagnostic analysis and programming for that age group.
When is 92604 used instead?
Use 92604 for subsequent cochlear implant reprogramming when the patient is 7 or older. Code 92602 is for patients younger than 7.
Should modifier 26 be appended?
No. CMS identifies this as a therapy service, for which the professional component modifier does not apply.
What documentation supports a subsequent reprogramming service?
Document the patient’s age, the cochlear implant, the reason for the visit, the programming adjustments, and relevant responses or findings.
Is this the code for an initial programming session?
No. For a patient younger than 7 receiving initial diagnostic analysis and programming, the related code is 92601.
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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