92601 Cochlear implt f/up exam <7
What 92601 is
CMS fee schedule short descriptor: Cochlear implt f/up exam <7.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 92601 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.30 | 2.31 | 0.01 | 4.62 | $154.31 |
| Facility (hospital, ASC) | 2.30 | 0.63 | 0.01 | 2.94 | $98.20 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 92601 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 92601? These codes are bundled into it
92601 is a Column 1 code in 53 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0208T | Audiometry air only | 0 - no modifier bypass | Check pair |
0209T | Audiometry air & bone | 0 - no modifier bypass | Check pair |
0210T | Speech audiometry threshold | 0 - no modifier bypass | Check pair |
0211T | Speech audiom thresh & recog | 0 - no modifier bypass | Check pair |
0212T | Compre audiometry evaluation | 0 - no modifier bypass | Check pair |
0485T | Oct mid ear i&r unilateral | 1 - modifier may bypass | Check pair |
0486T | Oct mid ear i&r bilateral | 1 - modifier may bypass | Check pair |
0728T | Dx alys vstblr implt uni 1st | 0 - no modifier bypass | Check pair |
0729T | Dx alys vstblr implt uni sbq | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
92507 | Tx sp lang voice comm indiv | 1 - modifier may bypass | Check pair |
92508 | Tx sp lang voice comm group | 1 - modifier may bypass | Check pair |
92521 | Evaluation of speech fluency | 1 - modifier may bypass | Check pair |
92522 | Evaluate speech production | 1 - modifier may bypass | Check pair |
92523 | Speech sound lang comprehen | 1 - modifier may bypass | Check pair |
92524 | Behavral qualit analys voice | 1 - modifier may bypass | Check pair |
92550 | Tympanometry & reflex thresh | 1 - modifier may bypass | Check pair |
92552 | Pure tone audiometry air | 0 - no modifier bypass | Check pair |
92553 | Audiometry air & bone | 0 - no modifier bypass | Check pair |
92555 | Speech threshold audiometry | 0 - no modifier bypass | Check pair |
92556 | Speech audiometry complete | 0 - no modifier bypass | Check pair |
92557 | Comprehensive hearing test | 0 - no modifier bypass | Check pair |
92558 | Evoked auditory test qual | 0 - no modifier bypass | Check pair |
92562 | Loudness balance test | 0 - no modifier bypass | Check pair |
92563 | Tone decay hearing test | 0 - no modifier bypass | Check pair |
92565 | Stenger test pure tone | 0 - no modifier bypass | Check pair |
92567 | Tympanometry | 1 - modifier may bypass | Check pair |
92568 | Acoustic refl threshold tst | 1 - modifier may bypass | Check pair |
92570 | Acoustic immitance testing | 1 - modifier may bypass | Check pair |
Showing 30 of 53 column 2 codes. Use the pair checker for any specific combination.
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.