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See a sample rate comparisonCPT 92626 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.
Hearing Therapy Assessment, Assessment Of Auditory Rehabilitation Status. Auditory Rehabilitation Is Training Or Therapy To Improve Hearing Skills And The Ability To Communicate.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $84.17 national non-facility rate (2026) · View Medicare rates for 92626 |
| Medicaid Fee Schedule | $68.15 median of the 7 states in the free preview · View Medicaid rates for 92626 |
National average reimbursement for CPT 92626 by major payers:
$106.31
$113.12
$114.42
$146.56
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CPT 92626
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$594.41Published rateAlyssa Stram
$166.13Published rateVictor Patron Romero
$154.32Published rateJeremiah Brewer
Loyola University Medical Center
$143.83Published rateDavid Kim
Town Center Orthopaedic Associates, P.C.
$70.06Published rate
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See a sample payer proposalCPT 92626 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92626 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 92626 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 |
|---|---|---|
| 92601-CPT | Moderate | Program Or Adjust Ear Implant, Programming Or Adjustment Of Cochlear Implant (Electronic Device Implanted In The Inner Ear To Create Sound Sensations. Used As Treatment For Deafness). |
| 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 92626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92626 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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