CPT 92651 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 15 - Mobile Unit • 11 - Office |
| Common Modifiers | • None • 32 • 52 - Reduced Services |
| Complexity Level | Low |
National average reimbursement for CPT 92651 by major payers:
$111.85
$120.41
$107.49
$150.71
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 92651 | ||||||
United | 92651 | $190.00 | 1558867523 - SULAIMAN FAROOQUI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92651 | $91.87 | 1730214206 - KALYANI GAVINI | 371158318 - (IL) SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92651 | $172.07 | 1689166027 - ANIRUDDHA DEKA | 911780160 | CT | Psychiatry Physician (2084P0800X) |
United | 92651 | $216.14 | 1659714806 - RAVI RAMASAMY | 910564748 - SEATTLE CHILDRENS HOSPITAL | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 92651 | $156.24 | 1407807746 - SYED KHAN | 320552496 | IN | Psychiatry Physician (2084P0800X) |
United | 92651 | $159.83 | 1851558001 - LUBOV ROMANTSEVA | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92651 | $177.08 | 1932272952 - MOHAMMED HOMSI | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92651 | $164.72 | 1710061486 - DAVID KEMP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92651 | $180.88 | 1508192048 - DIANA SIECIECHOWICZ | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92651 | $155.80 | 1013098631 - PAUL DOBRANSKY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 92651 | $571.76 | 1871912683 - LAUREN SCHUMACHER | 943281657 | IL | Psychiatry Physician (2084P0800X) |
United | 92651 | $176.22 | 1144203753 - HAIDAR KABBANI | 202305158 - TRIHEALTH G, LLC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 92651 | $162.44 | 1265753867 - ASIFA CHOUDHRY | 850703768 - (IL) CARLE WEST PHYSICIAN GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 92651 | $109.79 | 1861488132 - JYOTI WARIKOO | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 92651 | $155.80 | 1356352447 - MARLA HARTZEN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 92651 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92651 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 92651 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 |
|---|---|---|
| 92626-CPT | Low | Evaluation Of Auditory Function For Surgically Implanted Device(S) Candidacy Or Postoperative Status Of A Surgically Implanted Device(S); First Hour (Desc Rvsd 1/1/20) |
| 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) |
| 92650-CPT | Low | Auditory Evoked Potentials; Screening Of Auditory Potential With Broadband Stimuli Automated Analysis |
| 92651-CPT | Low | Auditory Evoked Potentials; For Hearing Status Determination Broadband Stimuli With Interpretation And Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92651. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92651 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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