Billing code 92616: Swallow evaluationMedicare rate & RVUs
Flexible endoscopic swallowing evaluation with laryngeal sensory testing assesses swallowing function and sensory response using recorded endoscopic observation and applied stimuli.
Medicare pays $228.80 for 92616 nationally in the office and $79.83 in a hospital or facility. Local office rates run $204.35–$307.51.
Medicare rate · 92616
Swallow evaluation
- Work RVUs
- 1.83
- Total RVUs
- 6.85
- Global days
- XXX
National rate · 2026
$228.80
Office setting, before claim adjustments.
See every locality for 92616 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 92616 covers
A clinician passes a flexible endoscope through the nose to view the pharynx and larynx during swallowing. The examination includes sensory testing by delivering stimuli to the laryngeal adductor mechanism and evaluating the response. Speech-language pathologists and otolaryngologists commonly perform or participate in this assessment in outpatient clinics, hospitals, and other settings where swallowing disorders are evaluated. Recorded views help document findings such as airway protection, residue, and the response to sensory stimulation.
Report 92616 for the endoscopic swallowing evaluation that includes this laryngeal sensory testing, rather than a swallowing assessment without endoscopy or sensory testing. The record should identify the endoscopic examination, the stimuli administered, observed sensory responses, swallowing findings, and the clinical interpretation. When the work is divided and only interpretation and reporting are performed, 92617 is the related code to consider. CMS values 92616 under the Physician Fee Schedule using work, practice-expense, and malpractice inputs; practice-expense values differ by office and facility setting.
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 92616 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$204.35 to $307.51
109 of 109 payment localities
92616 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.
$204.35
$276.07
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $269.05 | 1 |
| AL | $207.11 | 1 |
| AR | $204.35 | 1 |
| AZ | $223.33 | 1 |
| CA | $244.62–$307.51 | 29 |
| CO | $239.60 | 1 |
| CT | $243.24 | 1 |
| DC | $261.79 | 1 |
| DE | $226.88 | 1 |
| FL | $222.70–$239.15 | 3 |
| GA | $211.39–$232.09 | 2 |
| GU | $250.46 | 1 |
| HI | $250.46 | 1 |
| IA | $213.33 | 1 |
| ID | $214.34 | 1 |
| IL | $215.73–$235.49 | 4 |
| IN | $215.52 | 1 |
| KS | $211.76 | 1 |
| KY | $210.25 | 1 |
| LA | $209.68–$219.36 | 2 |
| MA | $238.06–$263.12 | 2 |
| MD | $231.20–$261.79 | 3 |
| ME | $214.69–$226.45 | 2 |
| MI | $214.71–$224.61 | 2 |
| MN | $231.94 | 1 |
| MO | $205.92–$220.86 | 3 |
| MS | $205.20 | 1 |
| MT | $228.79 | 1 |
| NC | $216.87 | 1 |
| ND | $227.41 | 1 |
| NE | $214.61 | 1 |
| NH | $235.28 | 1 |
| NJ | $246.68–$259.26 | 2 |
| NM | $215.54 | 1 |
| NV | $228.57 | 1 |
| NY | $219.84–$265.96 | 5 |
| OH | $214.43 | 1 |
| OK | $210.58 | 1 |
| OR | $227.44–$247.53 | 2 |
| PA | $215.11–$237.13 | 2 |
| PR | $230.58 | 1 |
| RI | $235.16 | 1 |
| SC | $215.88 | 1 |
| SD | $227.24 | 1 |
| TN | $212.67 | 1 |
| TX | $213.75–$238.24 | 8 |
| UT | $218.64 | 1 |
| VA | $225.30–$261.79 | 2 |
| VI | $230.58 | 1 |
| VT | $225.99 | 1 |
| WA | $237.79–$268.96 | 2 |
| WI | $220.23 | 1 |
| WV | $208.15 | 1 |
| WY | $228.19 | 1 |
How the 92616 rate is calculated
Each of 92616’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 · 92616
RVUs × geographic indexes × conversion factor
Work1.83
1.83 RVUs× 1.000 GPCI
Practice expense4.95
4.95 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
6.8500
Conversion factor
$33.4009
Medicare rate
$228.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92616
92616 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 92616
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$228.80
- Non-facility (office)
- $228.80
- Facility
- $79.83
Higher because the practice carries its own overhead.
92616 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 92612Swallowing endoscopy
- Use 92612 for endoscopic swallowing evaluation without the laryngeal sensory-testing service. 92616 includes administration and evaluation of sensory stimuli to the laryngeal adductor mechanism.
- 92614Laryngeal sensory test
- Both involve endoscopic swallowing assessment and sensory testing, but 92616 identifies sensory testing through stimuli to the laryngeal adductor mechanism. Match the code to the documented procedure.
- 92617FEES interpretation
- 92616 describes the endoscopic evaluation with sensory testing; 92617 is for interpretation and reporting only when that work is performed separately.
- 92611Swallow study
- 92611 evaluates swallowing with motion fluoroscopy. 92616 uses flexible endoscopy and includes laryngeal sensory testing.
92616 billing questions
How does 92616 differ from 92612?
92616 includes laryngeal sensory testing during the endoscopic swallowing evaluation. Use 92612 for the endoscopic evaluation without that sensory-testing element.
How does 92616 differ from 92614?
92616 specifically describes sensory testing through administration of stimuli to the laryngeal adductor mechanism. Select the code that matches the sensory-testing service actually performed and documented.
When should 92617 be considered?
92617 describes interpretation and reporting only for the endoscopic swallowing evaluation with laryngeal sensory testing. Consider it when that interpretive work is performed separately from the examination.
What documentation supports 92616?
Document the endoscopic examination, sensory stimuli administered, laryngeal response, swallowing observations, and the resulting clinical assessment.
Can a nonendoscopic swallowing evaluation be reported as 92616?
No. 92616 describes an endoscopic swallowing evaluation with laryngeal sensory testing; a nonendoscopic functional assessment is a different service.
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
Fee sheets
Put 92616 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →