`92603` Cochlear implt f/up exam 7/>

What 92603 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 92603 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	2.25	2.10	0.01	4.36	$145.63
Facility (hospital, ASC)	2.25	0.61	0.01	2.87	$95.86

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.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps 92603 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 92603? These codes are bundled into it

92603 is a Column 1 code in 52 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	1 - modifier may bypass	Check pair
`0729T`	Dx alys vstblr implt uni sbq	1 - modifier may 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 52 column 2 codes. Use the pair checker for any specific combination.

92603 is bundled into these codes

92603 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 92603 is the code that denies.

Column 1 code	Short description	Modifier indicator
`92601`	Cochlear implt f/up exam <7	0	Check pair

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.