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CPT code 92604: Cochlear implant programming, age 7 or older2026 Medicare rate & RVUs in Marin County, CA

An audiologist adjusts a cochlear implant user's processor settings for patients age 7 or older when programming changes are performed.

CMS RVU26DEffective Oct 1, 2026One payment locality29.1K Medicare services in 2024

In Marin County, CA, Medicare pays $109.92 for 92604 in the office and $61.88 when it’s performed in a hospital or facility.

$109.92Office (non-facility)
$61.88Hospital or facility
+25.6%vs the national office rate ($87.51)

Check a contract rate as a % of Medicare · 92604 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 92604 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Marin County, CA
  2. What 92604 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 92604 covers

An audiologist with cochlear implant expertise uses this service to adjust the processor's program or map for a patient age 7 or older. The work may include reviewing stimulation settings across channels and making changes based on the patient's listening experience, sound tolerance, or communication needs. It is commonly performed during audiology follow-up in an outpatient clinic or implant center.

Report the code when the encounter includes reprogramming, rather than diagnostic analysis alone or a visit that only reviews device function. Documentation should identify the programming work performed, the settings changed or reviewed, and the patient's response. CMS classifies this as a therapy service, and the professional component modifier does not apply; do not append modifier 26 to represent a separate professional portion.

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 Marin County, CA compares for 92604

Across 109 of 109 payment localities, the office rate for 92604 runs from $80.94 in Arkansas to $112.03 in San Benito County, CA. Marin County, CA pays $109.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

92604 in Marin County, CA vs other payment areas
  1. Marin County, CA · this page$109.92
  2. Bakersfield, CA · California$92.53−$17.39
  3. Chico, CA · California$92.43−$17.49
  4. El Centro, CA · California$92.43−$17.49
  5. Fresno, CA · California$92.43−$17.49
  6. Hanford, CA · California$92.43−$17.49
  7. Los Angeles, CA · California$97.42−$12.50

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

Every other payment area

92604 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$92.43$55.09
Merced, CACalifornia$92.43$55.09
Modesto, CACalifornia$92.43$55.09
Napa, CACalifornia$104.42$59.52
Oxnard, CACalifornia$96.82$56.55
Redding, CACalifornia$92.43$55.09
Rest of CaliforniaCalifornia$92.43$55.09
Riverside, CACalifornia$92.57$55.23

92604 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.

$80.94

$111.19

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

View every state and territory as a table
92604 office rate range by state
State / territoryOffice rate rangeLocalities
AK$111.191
AL$81.691
AR$80.941
AZ$86.051
CA$92.43–$112.0329
CO$90.851
CT$91.911
DC$97.891
DE$87.141
FL$85.68–$89.883
GA$82.67–$88.432
GU$93.591
HI$93.591
IA$83.451
ID$83.701
IL$83.75–$89.294
IN$84.021
KS$82.981
KY$82.441
LA$82.27–$84.882
MA$90.52–$98.002
MD$88.45–$97.893
ME$83.75–$86.982
MI$83.60–$86.152
MN$88.591
MO$81.23–$85.333
MS$81.111
MT$87.511
NC$84.351
ND$87.311
NE$83.801
NH$89.331
NJ$93.39–$97.432
NM$83.811
NV$87.501
NY$85.14–$99.055
OH$83.561
OK$82.581
OR$87.23–$93.142
PA$83.77–$90.192
PR$88.011
RI$89.771
SC$84.011
SD$87.291
TN$83.221
TX$83.40–$90.198
UT$84.751
VA$86.64–$97.892
VI$88.011
VT$86.891
WA$90.38–$99.852
WI$85.371
WV$81.701
WY$87.421

See 92604 in every payment locality

How the 92604 rate is calculated

Each of 92604’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 · 92604

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense1.36

1.36 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

2.6200

Conversion factor

$33.4009

Medicare rate

$87.51

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

The exact Marin County, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,862

Code
92604
Physician work
1.25
Practice expense
1.36
Malpractice
0.01

GPCI2026.csv

25

Locality
Marin County, CA
Physician work
1.095
Practice expense
1.410
Malpractice
0.459
Office calculation for 92604 in Marin County, CA
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0951.3687
Practice expense1.36× 1.4101.9176
Malpractice0.01× 0.4590.0046
Total RVUs3.2909
Conversion factor× 33.4009

Office rate, Marin County, CA$109.92

Office: (1.25 × 1.095 + 1.36 × 1.41 + 0.01 × 0.459) × $33.4009 = $109.92

Facility: (1.25 × 1.095 + 0.34 × 1.41 + 0.01 × 0.459) × $33.4009 = $61.88

Open 92604 in the RVU calculator

Payment rules and modifiers for 92604

The CMS indicators that decide how 92604 is paid alongside other services.

CMS payment indicators · 92604

Cochlear implant programming, age 7 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

92604 without CQ · national office

$87.51

Cochlear implant programming, age 7 or older

92604-CQ · Allowed amount unchanged

$87.51

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 92604

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

Codes related to 92604
CodeHow it relatesOffice range, Marin County, CA
Used instead
92602Implant reprogramming, subsequent, under age 7Reprogramming service for patients younger than 7.$123.05
Same family
92603Implant analysis, age seven or olderDiagnostic analysis of a cochlear implant for patients age 7 or older.$181.34
92601Cochlear implant, diagnostic analysis, under age 7Diagnostic analysis of a cochlear implant for patients younger than 7.$193.06

How 92604 has changed in Marin County, CA

92604 · Office / nonfacility

$109.92

Effective 2026-10-01

The base rate is $1.67 higher than on 2025-10-01, moving from $108.25 to $109.92 (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

    $108.25changed to$109.92

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.39 changed to 1.36
    • Malpractice RVU 0.03 changed to 0.01
    • Work GPCI 1.088 changed to 1.095
    • Practice expense GPCI 1.419 changed to 1.410
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $111.87changed to$108.25

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.40 changed to 1.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $110.04changed to$111.87

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.07changed to$110.04

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.43 changed to 1.40
    • Malpractice RVU 0.04 changed to 0.03
    • Work GPCI 1.082 changed to 1.088
    • Practice expense GPCI 1.374 changed to 1.419
    • Malpractice GPCI 0.487 changed to 0.470

  5. January 1, 2023

    RVU23A

    $112.77changed to$113.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.42 changed to 1.43
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.077 changed to 1.082
    • Practice expense GPCI 1.329 changed to 1.374
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $113.92changed to$112.77

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.45 changed to 1.42
    • Work GPCI 1.071 changed to 1.077
    • Practice expense GPCI 1.311 changed to 1.329

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $111.87changed to$113.92

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.34 changed to 1.45
    • Work GPCI 1.068 changed to 1.071
    • Practice expense GPCI 1.299 changed to 1.311
    • Malpractice GPCI 0.481 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $109.29changed to$111.87

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.30 changed to 1.34
    • Work GPCI 1.065 changed to 1.068
    • Practice expense GPCI 1.291 changed to 1.299
    • Malpractice GPCI 0.458 changed to 0.481

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $107.09changed to$109.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.27 changed to 1.30
    • Work GPCI 1.062 changed to 1.065
    • Practice expense GPCI 1.279 changed to 1.291

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $105.34changed to$107.09

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.25 changed to 1.27
    • Work GPCI 1.058 changed to 1.062
    • Practice expense GPCI 1.271 changed to 1.279
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$105.34

    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$109.92$61.88RVU26D
2026-07-01$109.92$61.88RVU26C
2026-04-01$109.92$61.88RVU26B
2026-01-01$109.92$61.88RVU26A
2025-10-01$108.25$76.12RVU25D
2025-07-01$108.25$76.12RVU25C
2025-04-01$108.25$76.12RVU25B
2025-01-01$108.25$76.12RVU25A
2024-10-01$111.87$77.39RVU24D
2024-07-01$111.87$77.39RVU24C
2024-04-01$111.87$77.39RVU24B
2024-03-09$111.87$77.39RVU24AR
2024-01-01$110.04$76.12RVU24A
2023-10-01$113.07$78.15RVU23D
2023-07-01$113.07$78.15RVU23C
2023-04-01$113.07$78.15RVU23B
2023-01-01$113.07$78.15RVU23A
2022-10-01$112.77$77.82RVU22D
2022-07-01$112.77$77.82RVU22C
2022-04-01$112.77$77.82RVU22B
2022-01-01$112.77$77.82RVU22A
2021-10-01$113.92$77.78RVU21D
2021-07-01$113.92$77.78RVU21C
2021-04-01$113.92$77.78RVU21B
2021-01-01$113.92$77.78RVU21A
2020-10-01$111.87$79.05RVU20D
2020-07-01$111.87$79.05RVU20C
2020-04-01$111.87$79.05RVU20B
2020-01-01$111.87$79.05RVU20A
2019-10-01$109.29$78.58RVU19D
2019-07-01$109.29$78.58RVU19C
2019-04-01$109.29$78.58RVU19B
2019-01-01$109.29$78.58RVU19A
2018-10-01$107.09$78.08RVU18D
2018-07-01$107.09$78.08RVU18C
2018-04-01$107.09$78.08RVU18B
2018-01-01$107.09$78.08RVU18AR1
2017-10-01$105.34$77.06RVU17D
2017-07-01$105.34$77.06RVU17C
2017-04-01$105.34$77.06RVU17B
2017-01-01$105.34$77.06RVU17A
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 92604 for an earlier date of service

Where the Marin County, CA rate applies

Marin County, CA is a Medicare payment area, not a city. Our Census mapping connects it to 31 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Alto
  • Belvedere
  • Black Point-Green Point
  • Bolinas
  • Corte Madera
  • Dillon Beach
  • Fairfax
  • Inverness

Browse all communities in California

92604 billing questions

How does this differ from 92603?

92604 represents processor reprogramming for a patient age 7 or older. 92603 is used for diagnostic analysis of a cochlear implant in this age group.

When should 92602 be used instead?

92602 describes cochlear implant reprogramming for a patient younger than 7. Use 92604 for patients age 7 or older.

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 reprogramming?

Document the programming performed, the processor settings reviewed or changed, and the patient's response or reason for the adjustment. A note describing diagnostic analysis alone supports a different service.

Is this a timed code or billed by electrode?

It is not a timed code. Report the reprogramming service, not a separate unit for each electrode or setting adjustment.

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 92604PPRRVU2026_Oct_nonQPP.csv, line 11,862 (RVU26D)
Geographic factors for Marin County, CAGPCI2026.csv, line 25 (RVU26D)

Open CMS sourceHow we calculate rates

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