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See a sample rate comparisonCPT 92640 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.
Diagnos Analy W/ Programm Of Auditory Brainstem Implnt Pe, Diagnostic Analysis With Programming Of Auditory Brainstem Implant Pe
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component RT - Right side of body 51 - Multiple procedures LT - Left side of body 76 - Repeat procedure by same physician |
| Complexity Level | Low |
| Medicare Fee Schedule | $106.22 national non-facility rate (2026) · View Medicare rates for 92640 |
| Medicaid Fee Schedule | $89.08 median of the 8 states in the free preview · View Medicaid rates for 92640 |
National average reimbursement for CPT 92640 by major payers:
$136.84
$131.24
$132.51
$155.68
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CPT 92640
5 of 25 sample ratesHigher to lower in this preview
Peter Heydemann
Pediatric Faculty Foundation In
$264.08Published rateJeremiah Brewer
Loyola University Medical Center
$219.38Published rateJeremiah Brewer
Loyola University Medical Center
$181.91Published rateMaria Fisfalen
Mount Sinai Community Foundation
$156.94Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$77.37Published rate
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See a sample payer proposalCPT 92640 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92640 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 92640 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). |
| 92603-CPT | Low | 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). |
| 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. |
| 92640-CPT | Low | Diagnos Analy W/ Programm Of Auditory Brainstem Implnt Pe, Diagnostic Analysis With Programming Of Auditory Brainstem Implant Pe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92640 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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