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See a sample rate comparisonCPT 92613 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Flexible Fiberoptic Endoscopic, Flexible Fiberoptic Endoscopic Evaluation Of Swallowing By Cine Or Video Recording Interpretation And Report Only
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | GN - Services delivered under an outpatient speech language pathology plan of care 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.74 national non-facility rate (2026) · View Medicare rates for 92613 |
| Medicaid Fee Schedule | $35.03 median of the 8 states in the free preview · View Medicaid rates for 92613 |
National average reimbursement for CPT 92613 by major payers:
$56.19
$49.45
$49.32
$60.65
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CPT 92613
5 of 25 sample ratesHigher to lower in this preview
Jeremy Wong
University Physicians Incorporated
$134.78Published rateSantosh Shrestha
Siu Physicians & Surgeons Inc
$74.01Published rateChristopher Raio
St Joseph Hospital
$64.11Published rateElizabeth Whitham
$44.27Published rateAndrew Kulik
Saint Anthony Health Affiliates
$33.02Published rate
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See a sample payer proposalCPT 92613 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92613 code is part of the Medicine Services and Procedures services used for Special Otorhinolaryngologic Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 92613 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 92610-CPT | Low | Evaluation Of Oral And Pharyngeal Swallowing Function |
| 92611-CPT | Low | Swallowing Evaluation, Evaluation Of Swallowing Ability Using A Scope (Fluoroscope). Fluoroscopy Is An X-Ray Technique That Shows Movement In Real-Time With The Aid Of Contrast Dye. |
| 92612-CPT | Moderate | Flex Fiberoptic Endoscopic Eval Of Swallowing By Cine Or Vid, Flexible Fiberoptic Endoscopic Evaluation Of Swallowing By Cine Or Vid |
| 92613-CPT | Low | Flexible Fiberoptic Endoscopic, Flexible Fiberoptic Endoscopic Evaluation Of Swallowing By Cine Or Video Recording Interpretation And Report Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92613. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92613 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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