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See a sample rate comparisonHealthcare 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.
| 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 | 52 - Reduced Services TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $88.51 national non-facility rate (2026) · View Medicare rates for 92620 |
| Medicaid Fee Schedule | $72.54 median of the 8 states in the free preview · View Medicaid rates for 92620 |
National average reimbursement for CPT 92620 by major payers:

$108.81

$109.98

$110.24

$133.36
Choose a payer to see a sample of rates for CPT 92620.
Adam Wallace
Aurora Medical Group Inc
Matthew Niedzwiecki
Poonam Jha
John Millichap
Grady Memorial Hospital Corporation
Adam Wallace
Rockford Health Physicians
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 92620 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92620 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 92620 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 |
|---|---|---|
| 92596-CPT | Low | Ear Protector Attenuatn Measuremnts |
| 92620-CPT | Low | Evaluate Hearing Function, Central Auditory Function Exam. Central Auditory Processes Are Responsible For What The Brain Does With What It Hears. |
| 92621-CPT | Low | Evaluation Of Central Auditory, Evaluation Of Central Auditory Function With Report Each Additional 15 Minutes (List Separately Inaddition To Code For Primary Procedure) |
| 92626-CPT | Low | Hearing Therapy Assessment, Assessment Of Auditory Rehabilitation Status. Auditory Rehabilitation Is Training Or Therapy To Improve Hearing Skills And The Ability To Communicate. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92620. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92620 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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