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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 | 59 - Distinct Procedural Service AB - Audiology service by audiologist |
| Complexity Level | Low |
| Medicare Fee Schedule | $65.80 national non-facility rate (2026) · View Medicare rates for 92625 |
| Medicaid Fee Schedule | $55.07 median of the 8 states in the free preview · View Medicaid rates for 92625 |
National average reimbursement for CPT 92625 by major payers:

$81.48

$85.26

$83.44

$105.33
Choose a payer to see a sample of rates for CPT 92625.
David Hsu
Aurora Medical Group Inc
Rhonda Lampen
Multicare Health System
Rosario Cosme Cruz
Anoosh Salman
Presence Healthcare Services
Ryan Miyamoto
Town Center Orthopaedic Associates, P.C.
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Rate Benchmarking
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See a sample payer proposalCPT 92625 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92625 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 92625 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 |
| 92625-CPT | Low | Assess Of Tinnitus (Inclu Pitch Loudness Matching & Masking, Assessment Of Tinnitus (Includes Pitch Loudness Matching And Masking |
| 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. |
| 92627-CPT | Low | Evaluation Of Auditory Function For Surgically Implanted Device(S) Candidacy Or Postoperative Status Of A Surgically Implanted Device(S); Each Additional 15 Minutes (List Separately In Addition To Code For Primary Procedure) (Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92625 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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