CPT code 92603: Implant analysis, age seven or older2026 Medicare rate & RVUs in Vallejo, CA

Follow-up diagnostic analysis and programming of a cochlear implant in a patient aged seven or older, including assessment of device function and auditory response.

CMS RVU26DEffective Oct 1, 2026One payment locality4K Medicare services in 2024

In Vallejo, CA, Medicare pays $172.49 for 92603 in the office and $106.89 when it’s performed in a hospital or facility.

$172.49Office (non-facility)
$106.89Hospital or facility
+18.4%vs the national office rate ($145.63)

Check a contract rate as a % of Medicare · 92603 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 92603 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vallejo, CA
  2. What 92603 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 92603 covers

An audiologist typically performs this follow-up analysis in an audiology clinic or hospital setting for a cochlear implant user aged seven or older. The visit assesses the implant system and the patient’s response, and may include checking or adjusting processor settings as part of the diagnostic analysis. It applies to adults and children who have reached age seven.

Select this code for the age-seven-or-older diagnostic analysis with programming, rather than a subsequent reprogramming service. The record should support the patient’s age, cochlear implant status, device and auditory findings, work performed, and any programming changes. CMS classifies the service as therapy: the professional component modifier does not apply, so do not append modifier 26.

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 Vallejo, CA compares for 92603

Across 109 of 109 payment localities, the office rate for 92603 runs from $135.58 in Arkansas to $187.61 in Alaska. Vallejo, CA pays $172.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

92603 in Vallejo, CA vs other payment areas
  1. Vallejo, CA · this page$172.49
  2. Bakersfield, CA · California$153.66−$18.83
  3. Chico, CA · California$153.48−$19.01
  4. El Centro, CA · California$153.49−$19.00
  5. Fresno, CA · California$153.48−$19.01
  6. Hanford, CA · California$153.48−$19.01
  7. Los Angeles, CA · California$161.43−$11.06

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

Every other payment area

92603 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$153.48$98.94
Merced, CACalifornia$153.48$98.94
Modesto, CACalifornia$153.48$98.94
Napa, CACalifornia$172.50$106.91
Oxnard, CACalifornia$160.37$101.55
Redding, CACalifornia$153.48$98.94
Rest of CaliforniaCalifornia$153.48$98.94
Riverside, CACalifornia$153.67$99.12

92603 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.

$135.58

$187.61

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

View every state and territory as a table
92603 office rate range by state
State / territoryOffice rate rangeLocalities
AK$187.611
AL$136.721
AR$135.581
AZ$143.411
CA$153.48–$184.7429
CO$150.951
CT$152.601
DC$162.211
DE$145.131
FL$142.71–$149.013
GA$138.12–$147.042
GU$155.101
HI$155.101
IA$139.461
ID$139.841
IL$139.71–$148.314
IN$140.341
KS$138.731
KY$137.811
LA$137.55–$141.532
MA$150.48–$162.282
MD$147.19–$162.213
ME$139.89–$144.872
MI$139.57–$143.402
MN$147.431
MO$135.94–$142.263
MS$135.791
MT$145.631
NC$140.811
ND$145.431
NE$140.021
NH$148.461
NJ$155.12–$161.612
NM$139.871
NV$145.641
NY$142.02–$163.985
OH$139.531
OK$138.051
OR$145.25–$154.532
PA$139.86–$149.922
PR$146.391
RI$149.331
SC$140.251
SD$145.411
TN$139.091
TX$139.29–$149.818
UT$141.391
VA$144.34–$162.212
VI$146.391
VT$144.761
WA$150.24–$165.252
WI$142.451
WV$136.581
WY$145.541

See 92603 in every payment locality

How the 92603 rate is calculated

Each of 92603’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 · 92603

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.25

2.25 RVUs× 1.000 GPCI

Practice expense2.10

2.10 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

4.3600

Conversion factor

$33.4009

Medicare rate

$145.63

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

The exact Vallejo, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,861

Code
92603
Physician work
2.25
Practice expense
2.10
Malpractice
0.01

GPCI2026.csv

33

Locality
Vallejo, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office calculation for 92603 in Vallejo, CA
ComponentRVULocality factorAdjusted
Physician work2.25× 1.0632.3918
Practice expense2.10× 1.3182.7678
Malpractice0.01× 0.4590.0046
Total RVUs5.1641
Conversion factor× 33.4009

Office rate, Vallejo, CA$172.49

Office: (2.25 × 1.063 + 2.1 × 1.318 + 0.01 × 0.459) × $33.4009 = $172.49

Facility: (2.25 × 1.063 + 0.61 × 1.318 + 0.01 × 0.459) × $33.4009 = $106.89

Open 92603 in the RVU calculator

Payment rules and modifiers for 92603

The CMS indicators that decide how 92603 is paid alongside other services.

CMS payment indicators · 92603

Implant analysis, age seven or older

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

92603 without CQ · national office

$145.63

Implant analysis, age seven or older

92603-CQ · Allowed amount unchanged

$145.63

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 92603 has changed in Vallejo, CA

92603 · Office / nonfacility

$172.49

Effective 2026-10-01

The base rate is $4.47 higher than on 2025-10-01, moving from $168.02 to $172.49 (2.7%).

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

    $168.02changed to$172.49

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.13 changed to 2.10
    • Malpractice RVU 0.05 changed to 0.01
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $173.50changed to$168.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.14 changed to 2.13
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $170.67changed to$173.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $175.00changed to$170.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.19 changed to 2.14
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.487 changed to 0.470
  5. January 1, 2023

    RVU23A

    $174.48changed to$175.00

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.17 changed to 2.19
    • Malpractice RVU 0.09 changed to 0.06
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $177.20changed to$174.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.20 changed to 2.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $179.28changed to$177.20

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.07 changed to 2.20
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $178.92changed to$179.28

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.03 changed to 2.07
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $177.37changed to$178.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.00 changed to 2.03

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $176.30changed to$177.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.96 changed to 2.00
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$176.30

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$172.49$106.89RVU26D
2026-07-01$172.49$106.89RVU26C
2026-04-01$172.49$106.89RVU26B
2026-01-01$172.49$106.89RVU26A
2025-10-01$168.02$130.30RVU25D
2025-07-01$168.02$130.30RVU25C
2025-04-01$168.02$130.30RVU25B
2025-01-01$168.02$130.30RVU25A
2024-10-01$173.50$132.94RVU24D
2024-07-01$173.50$132.94RVU24C
2024-04-01$173.50$132.94RVU24B
2024-03-09$173.50$132.94RVU24AR
2024-01-01$170.67$130.77RVU24A
2023-10-01$175.00$133.42RVU23D
2023-07-01$175.00$133.42RVU23C
2023-04-01$175.00$133.42RVU23B
2023-01-01$175.00$133.42RVU23A
2022-10-01$174.48$133.10RVU22D
2022-07-01$174.48$133.10RVU22C
2022-04-01$174.48$133.10RVU22B
2022-01-01$174.48$133.10RVU22A
2021-10-01$177.20$134.20RVU21D
2021-07-01$177.20$134.20RVU21C
2021-04-01$177.20$134.20RVU21B
2021-01-01$177.20$134.20RVU21A
2020-10-01$179.28$137.73RVU20D
2020-07-01$179.28$137.73RVU20C
2020-04-01$179.28$137.73RVU20B
2020-01-01$179.28$137.73RVU20A
2019-10-01$178.92$138.18RVU19D
2019-07-01$178.92$138.18RVU19C
2019-04-01$178.92$138.18RVU19B
2019-01-01$178.92$138.18RVU19A
2018-10-01$177.37$138.03RVU18D
2018-07-01$177.37$138.03RVU18C
2018-04-01$177.37$138.03RVU18B
2018-01-01$177.37$138.03RVU18AR1
2017-10-01$176.30$138.44RVU17D
2017-07-01$176.30$138.44RVU17C
2017-04-01$176.30$138.44RVU17B
2017-01-01$176.30$138.44RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
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 92603 for an earlier date of service

Where the Vallejo, CA rate applies

Vallejo, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Vallejo
  • Allendale
  • Benicia
  • Dixon
  • Elmira
  • Fairfield
  • Green Valley
  • Hartley

Browse all communities in California

92603 billing questions

How does this differ from 92604?

92603 represents diagnostic analysis with programming for a patient aged seven or older. Use 92604 for subsequent reprogramming.

Which code applies to a patient younger than seven?

Use 92601 for diagnostic analysis with programming in a patient younger than seven. Code 92602 represents subsequent reprogramming for that age group.

Can modifier 26 be appended?

No. CMS identifies this as a therapy service for which the professional component modifier does not apply.

What documentation supports reporting 92603?

Document the patient’s age and implant status, the diagnostic assessment of the device and auditory response, and any programming performed.

Is 92603 the code for every cochlear implant follow-up?

No. The patient must be at least seven, and the service must be diagnostic analysis with programming rather than subsequent reprogramming.

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 92603PPRRVU2026_Oct_nonQPP.csv, line 11,861 (RVU26D)
Geographic factors for Vallejo, CAGPCI2026.csv, line 33 (RVU26D)

Open CMS sourceHow we calculate rates

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