$91.91
Use 92603 for diagnostic analysis with programming in a patient aged seven or older; 92604 is for subsequent reprogramming.
On this page
CMS RVU26D · Effective 2026-10-01
92603 Implant analysis Medicare reimbursement rates in Connecticut
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. Compare 92603 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92603 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$152.60
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$99.00
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Audiology
About 92603: Cochlear implant follow-up analysis, age seven or older
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.
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.
CMS billing rules for 92603
- Professional and technical components
- Therapy service: the professional component modifier does not apply.
Where the value comes from
- Work RVU2.25 · 52%
- Practice expense (office) RVU2.10 · 48%
- Malpractice RVU0.01 · 0%
4K
Medicare services in 2024 · #1992 by national volume
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.
92603 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$161.86
Both represent diagnostic analysis with programming, but 92601 is for patients younger than seven; 92603 is for patients aged seven or older.
$102.25
92602 is subsequent reprogramming for a patient younger than seven. For a patient aged seven or older, subsequent reprogramming is reported with 92604.
Compare 92603 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$152.60
Facility
$99.00
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92603 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
11,861
- Code
- 92603
- Physician work
- 2.25
- Practice expense
- 2.10
- Malpractice
- 0.01
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.25 | × 1.020 | 2.2950 |
| Practice expense | 2.10 | × 1.077 | 2.2617 |
| Malpractice | 0.01 | × 1.210 | 0.0121 |
| Total RVUs | 4.5688 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$152.60
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1.02 |
| Practice expense | 2.1 | 1.077 |
| Malpractice | 0.01 | 1.21 |
(2.25 × 1.02 + 2.1 × 1.077 + 0.01 × 1.21) × $33.4009 = $152.60
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.25 | 1.02 |
| Practice expense | 0.61 | 1.077 |
| Malpractice | 0.01 | 1.21 |
(2.25 × 1.02 + 0.61 × 1.077 + 0.01 × 1.21) × $33.4009 = $99.00
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,85892597,,Oral speech device eval,A,,1.23,0.88,,0.88,NA,0.02,2.13,2.13,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,85992601,,Cochlear implt f/up exam <7,A,,2.30,2.31,,0.63,,0.01,4.62,2.94,7,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,86092602,,Reprogram cochlear implt <7,A,,1.30,1.60,,0.36,,0.01,2.91,1.67,7,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,86192603,,Cochlear implt f/up exam 7/>,A,,2.25,2.10,,0.61,,0.01,4.36,2.87,7,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,86292604,,Reprogram cochlear implt 7/>,A,,1.25,1.36,,0.34,,0.01,2.62,1.60,7,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,86392605,,Ex for nonspeech device rx,B,+,1.75,0.93,,0.38,,0.11,2.79,2.24,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,86492606,,Non-speech device service,B,+,1.37,0.93,,0.30,,0.08,2.38,1.75,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808