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CPT code 92603: Implant analysis, age seven or older2026 Medicare rate & RVUs in Washington, DC area

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 Washington, DC area, Medicare pays $162.21 for 92603 in the office and $103.58 when it’s performed in a hospital or facility.

$162.21Office (non-facility)
$103.58Hospital or facility
+11.4%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 Washington, DC area
  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 Washington, DC area 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. Washington, DC area pays $162.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

92603 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$162.21
  2. Los Angeles, CA · California$161.43−$0.78
  3. Miami, FL · Florida$149.01−$13.20
  4. Chicago, IL · Illinois$146.94−$15.27
  5. Manhattan, NY · New York$162.00−$0.21
  6. Alaska · Alaska$187.61+$25.40
  7. Alabama · Alabama$136.72−$25.49

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

92603 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$135.58$92.83
ArizonaArizona$143.41$95.18
Bakersfield, CACalifornia$153.66$99.11
Chico, CACalifornia$153.48$98.94
El Centro, CACalifornia$153.49$98.94
Fresno, CACalifornia$153.48$98.94
Hanford, CACalifornia$153.48$98.94
Madera, CACalifornia$153.48$98.94

92603 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.

$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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 92603 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work2.25× 1.0542.3715
Practice expense2.10× 1.1782.4738
Malpractice0.01× 1.1130.0111
Total RVUs4.8564
Conversion factor× 33.4009

Office rate, Washington, DC area$162.21

Office: (2.25 × 1.054 + 2.1 × 1.178 + 0.01 × 1.113) × $33.4009 = $162.21

Facility: (2.25 × 1.054 + 0.61 × 1.178 + 0.01 × 1.113) × $33.4009 = $103.58

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.

Codes related to 92603

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 92603
CodeHow it relatesOffice range, Washington, DC area
Same family
92601Cochlear implant, diagnostic analysis, under age 7Diagnostic analysis with programming for a cochlear implant patient younger than seven.$172.23
92602Implant reprogramming, subsequent, under age 7Subsequent cochlear implant reprogramming for a patient younger than seven.$109.09
92604Cochlear implant programming, age 7 or olderSubsequent cochlear implant reprogramming for a patient aged seven or older.$97.89

How 92603 has changed in Washington, DC area

92603 · Office / nonfacility

$162.21

Effective 2026-10-01

The base rate is $1.27 higher than on 2025-10-01, moving from $160.94 to $162.21 (0.8%).

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

    $160.94changed to$162.21

    • 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 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $166.41changed to$160.94

    • 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

    $163.70changed to$166.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $173.11changed to$163.70

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.19 changed to 2.14
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $178.92changed to$173.11

    • 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 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $181.69changed to$178.92

    • 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

    $180.54changed to$181.69

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.07 changed to 2.20
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $176.98changed to$180.54

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.03 changed to 2.07
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $175.49changed to$176.98

    • 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

    $173.49changed to$175.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.96 changed to 2.00
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $172.52changed to$173.49

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.93 changed to 1.96
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $170.08changed to$172.52

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.87 changed to 1.93
    • Malpractice RVU 0.09 changed to 0.10

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $169.24changed to$170.08

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $166.46changed to$169.24

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.79 changed to 1.87
    • Malpractice RVU 0.11 changed to 0.09
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $164.42changed to$166.46

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.96 changed to 1.79
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $164.42

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$162.21$103.58RVU26D
2026-07-01$162.21$103.58RVU26C
2026-04-01$162.21$103.58RVU26B
2026-01-01$162.21$103.58RVU26A
2025-10-01$160.94$126.63RVU25D
2025-07-01$160.94$126.63RVU25C
2025-04-01$160.94$126.63RVU25B
2025-01-01$160.94$126.63RVU25A
2024-10-01$166.41$129.51RVU24D
2024-07-01$166.41$129.51RVU24C
2024-04-01$166.41$129.51RVU24B
2024-03-09$166.41$129.51RVU24AR
2024-01-01$163.70$127.40RVU24A
2023-10-01$173.11$133.21RVU23D
2023-07-01$173.11$133.21RVU23C
2023-04-01$173.11$133.21RVU23B
2023-01-01$173.11$133.21RVU23A
2022-10-01$178.92$137.00RVU22D
2022-07-01$178.92$137.00RVU22C
2022-04-01$178.92$137.00RVU22B
2022-01-01$178.92$137.00RVU22A
2021-10-01$181.69$138.13RVU21D
2021-07-01$181.69$138.13RVU21C
2021-04-01$181.69$138.13RVU21B
2021-01-01$181.69$138.13RVU21A
2020-10-01$180.54$139.56RVU20D
2020-07-01$180.54$139.56RVU20C
2020-04-01$180.54$139.56RVU20B
2020-01-01$180.54$139.56RVU20A
2019-10-01$176.98$137.90RVU19D
2019-07-01$176.98$137.90RVU19C
2019-04-01$176.98$137.90RVU19B
2019-01-01$176.98$137.90RVU19A
2018-10-01$175.49$137.75RVU18D
2018-07-01$175.49$137.75RVU18C
2018-04-01$175.49$137.75RVU18B
2018-01-01$175.49$137.75RVU18AR1
2017-10-01$173.49$137.60RVU17D
2017-07-01$173.49$137.60RVU17C
2017-04-01$173.49$137.60RVU17B
2017-01-01$173.49$137.60RVU17A
2016-10-01$172.52$137.57RVU16D
2016-07-01$172.52$137.57RVU16C
2016-04-01$172.52$137.57RVU16B
2016-01-01$172.52$137.57RVU16A
2015-10-01$170.08$137.18RVU15D
2015-07-01$170.08$137.18RVU15C
2015-04-01$169.24$136.49RVU15B
2015-01-01$169.24$136.49RVU15A
2014-10-01$166.46$137.18RVU14D
2014-07-01$166.46$137.18RVU14C
2014-04-01$166.46$137.18RVU14B
2014-01-01$166.46$137.18RVU14A
2013-10-01$164.42$133.04RVU13D
2013-07-01$164.42$133.04RVU13C
2013-04-01$164.42$133.04RVU13B
2013-01-01$164.42$133.04RVU13AR

Price 92603 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

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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 Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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