Billing code 92620: Implant auditory evaluationMedicare rate & RVUs in Delaware
Reports an hour of auditory function evaluation to assess candidacy for, or performance of, a surgically implanted hearing device.
Medicare pays $88.27 for 92620 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
What 92620 covers
An audiologist typically performs this evaluation in an outpatient audiology or otolaryngology setting for a patient being considered for an implanted auditory device or whose implanted device performance needs assessment. The service evaluates auditory function in relation to the device and supports clinical decisions about candidacy or how the patient is hearing with the implant. The focus is auditory function, not simply a general hearing assessment or device programming alone.
Report 92620 for the per-hour evaluation and document the clinical purpose, relevant device status, testing performed, findings, and time. When additional evaluation time qualifies, 92621 is the companion code for each additional 15 minutes. CMS prices 92620 as bilateral; modifier 50 does not increase its payment. Documentation should make clear whether the assessment concerns candidacy or performance and which ears or implanted devices were evaluated.
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.
92620 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $88.27 | $64.18 |
How the 92620 rate is calculated
Each of 92620’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 · 92620
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.50Practice expense 1.14Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92620
The CMS indicators that decide how 92620 is paid alongside other services.
CMS payment indicators · 92620
Implant auditory evaluation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 9 | The concept doesn’t apply. |
92620 compared with similar codes
Compare codes
92620 vs 92621 vs 92622 vs 92626 vs 92628: national Medicare rates
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How to choose
- 92621Auditory function
- 92620 reports the per-hour implant-related auditory function evaluation. 92621 is its add-on for each additional 15 minutes, not a substitute for the initial service.
- 92622Processor analysis
- Choose 92620 for evaluation of auditory function tied to device candidacy or performance. 92622 is for diagnostic analysis of an implantable hearing device.
- 92626Auditory evaluation
- 92620 focuses on surgically implanted-device candidacy or performance; 92626 evaluates auditory rehabilitation status.
- 92628Eval hearing aid cand 1st 30
- 92628 concerns evaluation for hearing-aid candidacy. 92620 concerns auditory function evaluation for a surgically implanted device.
92620 billing questions
When should 92620 be reported?
Use it for an hour of auditory function evaluation related to candidacy for, or performance of, a surgically implanted auditory device. A general hearing assessment without that implant-related purpose is not the service described here.
How is additional evaluation time reported?
92621 is the add-on code for each additional 15 minutes after the 92620 service. Document the time spent on the implant-related auditory function evaluation.
Should modifier 50 be appended for evaluation of both ears?
CMS prices 92620 as bilateral, and modifier 50 does not increase payment. Document the ears evaluated, but do not use modifier 50 to seek increased payment.
How does 92620 differ from 92622?
92620 addresses auditory function evaluation for implanted-device candidacy or performance. Consider 92622 when the service is diagnostic analysis of an implantable hearing device rather than this broader evaluation.
How does 92620 differ from 92626?
92620 is tied to candidacy for or performance of a surgically implanted auditory device. 92626 concerns evaluation of auditory rehabilitation status, rather than that implant-specific purpose.
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
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