CPT 92516
Global XXX ActiveFacial nerve function test
CPT 92516 Billing & Documentation Guide
CPT code 92516 (Facial nerve function test) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.42, a non-facility practice expense RVU of 1.8, and a malpractice RVU of 0.03, a total non-facility RVU of 2.25 and facility RVU of 0.56. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $77.92, though rates vary from $66.19 to $102.8 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92516, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92516 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 92516 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92516
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.42 | 0.42 |
| Practice Expense RVU | 1.8 | 0.11 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 2.25 | 0.56 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92516
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $86.22 | $19.42 | $80.7 - $102.8 | 29 |
| Florida | $76.3 | $19.67 | $73.01 - $79.15 | 3 |
| Georgia | $72.6 | $18.76 | $68.85 - $76.36 | 2 |
| Illinois | $74.09 | $19.55 | $70.49 - $77.65 | 4 |
| Michigan | $71.9 | $18.89 | $70.05 - $73.74 | 2 |
| North Carolina | $70.76 | $18.1 | $70.76 - $70.76 | 1 |
| New York | $83.13 | $20.15 | $71.85 - $88.27 | 5 |
| Ohio | $69.93 | $18.39 | $69.93 - $69.93 | 1 |
| Pennsylvania | $74.12 | $18.83 | $70.17 - $78.06 | 2 |
| Texas | $74.23 | $18.65 | $69.67 - $78.55 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92516
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92516 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99201 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99202 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99203 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99204 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99205 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99211 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99212 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 92516
What does CPT code 92516 mean? +
CPT code 92516 represents: Facial nerve function test. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92516? +
The 2026 Medicare national average non-facility payment for CPT 92516 is $77.92. Rates range from $66.19 to $102.8 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92516? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92516? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team