$20.55
92626 covers the initial hour of the implanted-device auditory evaluation. Use 92627 for each additional 15 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
92626 Auditory evaluation Medicare reimbursement rates in Rhode Island
Evaluates auditory function for a patient being considered for a surgically implanted hearing device or assessed after implantation during the initial hour. Compare 92626 office and facility rates across CMS payment localities in Rhode Island.
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 92626 in Rhode Island?
Rhode Island 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
$86.25
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$61.06
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 92626: Implanted hearing device auditory evaluation
Evaluates auditory function for a patient being considered for a surgically implanted hearing device or assessed after implantation during the initial hour.
An audiologist evaluates auditory function when a patient is being considered for a surgically implanted hearing device or is being assessed after implantation. The assessment may use structured measures of sound detection and speech understanding to characterize functional hearing and device benefit. Common settings include audiology clinics and hospital-based audiology departments, such as during a cochlear implant candidacy workup or after implantation.
Report 92626 for the initial hour devoted to this device-focused evaluation. Document the clinical purpose, tests performed, findings, and time. Use 92627 for each additional 15 minutes when the service extends beyond the initial hour. Choose this code for evaluation related to candidacy for or status after a surgically implanted auditory device, rather than a routine hearing assessment or hearing-aid candidacy evaluation. CMS pricing treats 92626 as bilateral, so modifier 50 does not increase payment when both ears are assessed.
CMS billing rules for 92626
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU1.40 · 56%
- Practice expense (office) RVU1.11 · 44%
- Malpractice RVU0.01 · 0%
22.2K
Medicare services in 2024 · #1106 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.
92626 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$90.68
92620 addresses auditory-function evaluation for hearing assessment generally; 92626 is selected when the evaluation concerns candidacy for or status after a surgically implanted auditory device.
92628
No office rateEval hearing aid cand 1st 30
92628 evaluates candidacy for hearing aids. Use 92626 when the evaluation concerns a surgically implanted auditory device.
Compare 92626 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
Rhode Island →
Office / nonfacility
$86.25
Facility
$61.06
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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 92626 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
11,882
- Code
- 92626
- Physician work
- 1.40
- Practice expense
- 1.11
- Malpractice
- 0.01
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.40 | × 1.019 | 1.4266 |
| Practice expense | 1.11 | × 1.033 | 1.1466 |
| Malpractice | 0.01 | × 0.892 | 0.0089 |
| Total RVUs | 2.5821 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$86.25
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.4 | 1.019 |
| Practice expense | 1.11 | 1.033 |
| Malpractice | 0.01 | 0.892 |
(1.4 × 1.019 + 1.11 × 1.033 + 0.01 × 0.892) × $33.4009 = $86.25
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.4 | 1.019 |
| Practice expense | 0.38 | 1.033 |
| Malpractice | 0.01 | 0.892 |
(1.4 × 1.019 + 0.38 × 1.033 + 0.01 × 0.892) × $33.4009 = $61.06
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.
92626 billing questions
When should I choose 92626 instead of 92620?
Use 92626 when the auditory evaluation concerns candidacy for a surgically implanted hearing device or postoperative status. Code 92620 is for auditory-function evaluation not specifically tied to that implanted-device purpose.
How is additional time reported?
Code 92626 represents the initial hour. Report 92627 for each additional 15 minutes when the evaluation continues beyond that hour, and document the time spent.
Should I append modifier 50 when both ears are evaluated?
No. CMS pricing already treats 92626 as bilateral, and modifier 50 does not increase payment.
What documentation supports 92626?
Document whether the evaluation addresses implanted-device candidacy or postoperative status, the auditory measures performed, the findings, and the time devoted to the service.
Is hearing-aid candidacy evaluated with 92626?
No. For an evaluation of hearing-aid candidacy, consider the hearing-aid candidacy service code instead; 92626 is specific to a surgically implanted auditory device.
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.
11,87992622,,Dx aly aud oi snd prcsr 1st,A,,1.25,1.06,,0.35,,0.01,2.32,1.61,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,88092623,,Dx aly aud oi snd prcsr each,A,,0.33,0.27,,0.09,,0.00,0.60,0.42,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,88192625,,Tinnitus assessment,A,,1.15,0.80,,0.31,,0.02,1.97,1.48,9,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,88292626,,Eval aud funcj 1st hour,A,,1.40,1.11,,0.38,,0.01,2.52,1.79,0,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,88392627,,Eval aud funcj ea addl 15,A,,0.33,0.27,,0.09,,0.00,0.60,0.42,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,88492628,,Eval hearing aid cand 1st 30,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,88592629,,Eval hearing aid cand ea add,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537