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

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 Delaware, Medicare pays $145.13 for 92603 in the office and $95.96 when it’s performed in a hospital or facility.

$145.13Office (non-facility)
$95.96Hospital or facility
−0.3%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 Delaware
  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 Delaware 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. Delaware pays $145.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

92603 in Delaware vs other payment areas
  1. Delaware · this page$145.13
  2. Los Angeles, CA · California$161.43+$16.30
  3. Washington, DC area · District of Columbia$162.21+$17.08
  4. Miami, FL · Florida$149.01+$3.88
  5. Chicago, IL · Illinois$146.94+$1.81
  6. Manhattan, NY · New York$162.00+$16.87
  7. Alaska · Alaska$187.61+$42.48

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

Every other payment area

92603 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$136.72$93.17
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

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 Delaware 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

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 92603 in Delaware
ComponentRVULocality factorAdjusted
Physician work2.25× 1.0052.2612
Practice expense2.10× 0.9882.0748
Malpractice0.01× 0.8990.0090
Total RVUs4.3450
Conversion factor× 33.4009

Office rate, Delaware$145.13

Office: (2.25 × 1.005 + 2.1 × 0.988 + 0.01 × 0.899) × $33.4009 = $145.13

Facility: (2.25 × 1.005 + 0.61 × 0.988 + 0.01 × 0.899) × $33.4009 = $95.96

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, Delaware
Same family
92601Cochlear implant, diagnostic analysis, under age 7Diagnostic analysis with programming for a cochlear implant patient younger than seven.$153.74
92602Implant reprogramming, subsequent, under age 7Subsequent cochlear implant reprogramming for a patient younger than seven.$96.74
92604Cochlear implant programming, age 7 or olderSubsequent cochlear implant reprogramming for a patient aged seven or older.$87.14

How 92603 has changed in Delaware

92603 · Office / nonfacility

$145.13

Effective 2026-10-01

The base rate is $1.81 higher than on 2025-10-01, moving from $143.32 to $145.13 (1.3%).

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

    $143.32changed to$145.13

    • 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 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $148.13changed to$143.32

    • 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

    $145.71changed to$148.13

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $153.42changed to$145.71

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.19 changed to 2.14
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $157.89changed to$153.42

    • 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 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $160.27changed to$157.89

    • 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

    $161.29changed to$160.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.07 changed to 2.20
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $159.83changed to$161.29

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.03 changed to 2.07
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $158.56changed to$159.83

    • 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

    $157.21changed to$158.56

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.96 changed to 2.00
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $156.65changed to$157.21

    • 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 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $154.60changed to$156.65

    • 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

    $153.83changed to$154.60

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $151.59changed to$153.83

    • 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
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $149.60changed to$151.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.96 changed to 1.79
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $149.60

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$145.13$95.96RVU26D
2026-07-01$145.13$95.96RVU26C
2026-04-01$145.13$95.96RVU26B
2026-01-01$145.13$95.96RVU26A
2025-10-01$143.32$114.76RVU25D
2025-07-01$143.32$114.76RVU25C
2025-04-01$143.32$114.76RVU25B
2025-01-01$143.32$114.76RVU25A
2024-10-01$148.13$117.42RVU24D
2024-07-01$148.13$117.42RVU24C
2024-04-01$148.13$117.42RVU24B
2024-03-09$148.13$117.42RVU24AR
2024-01-01$145.71$115.51RVU24A
2023-10-01$153.42$120.32RVU23D
2023-07-01$153.42$120.32RVU23C
2023-04-01$153.42$120.32RVU23B
2023-01-01$153.42$120.32RVU23A
2022-10-01$157.89$123.23RVU22D
2022-07-01$157.89$123.23RVU22C
2022-04-01$157.89$123.23RVU22B
2022-01-01$157.89$123.23RVU22A
2021-10-01$160.27$124.25RVU21D
2021-07-01$160.27$124.25RVU21C
2021-04-01$160.27$124.25RVU21B
2021-01-01$160.27$124.25RVU21A
2020-10-01$161.29$127.02RVU20D
2020-07-01$161.29$127.02RVU20C
2020-04-01$161.29$127.02RVU20B
2020-01-01$161.29$127.02RVU20A
2019-10-01$159.83$126.78RVU19D
2019-07-01$159.83$126.78RVU19C
2019-04-01$159.83$126.78RVU19B
2019-01-01$159.83$126.78RVU19A
2018-10-01$158.56$126.64RVU18D
2018-07-01$158.56$126.64RVU18C
2018-04-01$158.56$126.64RVU18B
2018-01-01$158.56$126.64RVU18AR1
2017-10-01$157.21$126.68RVU17D
2017-07-01$157.21$126.68RVU17C
2017-04-01$157.21$126.68RVU17B
2017-01-01$157.21$126.68RVU17A
2016-10-01$156.65$126.75RVU16D
2016-07-01$156.65$126.75RVU16C
2016-04-01$156.65$126.75RVU16B
2016-01-01$156.65$126.75RVU16A
2015-10-01$154.60$126.45RVU15D
2015-07-01$154.60$126.45RVU15C
2015-04-01$153.83$125.82RVU15B
2015-01-01$153.83$125.82RVU15A
2014-10-01$151.59$126.30RVU14D
2014-07-01$151.59$126.30RVU14C
2014-04-01$151.59$126.30RVU14B
2014-01-01$151.59$126.30RVU14A
2013-10-01$149.60$122.25RVU13D
2013-07-01$149.60$122.25RVU13C
2013-04-01$149.60$122.25RVU13B
2013-01-01$149.60$122.25RVU13AR

Price 92603 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

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 DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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