CPT 92597
Global XXX ActiveOral speech device eval
CPT 92597 Billing & Documentation Guide
CPT code 92597 (Oral speech device eval) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.23, a non-facility practice expense RVU of 0.88, and a malpractice RVU of 0.02, a total non-facility RVU of 2.13 and facility RVU of 2.13. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $73.17, though rates vary from $66.68 to $93.3 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92597, 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 92597 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 92597 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 92597
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.23 | 1.23 |
| Practice Expense RVU | 0.88 | 0.88 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 2.13 | 2.13 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92597
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 | $77.7 | $77.7 | $74.35 - $88.34 | 29 |
| Florida | $71.88 | $71.88 | $70.19 - $73.37 | 3 |
| Georgia | $69.99 | $69.99 | $68.1 - $71.87 | 2 |
| Illinois | $70.9 | $70.9 | $68.96 - $72.74 | 4 |
| Michigan | $69.62 | $69.62 | $68.67 - $70.57 | 2 |
| North Carolina | $68.93 | $68.93 | $68.93 - $68.93 | 1 |
| New York | $76.73 | $76.73 | $69.48 - $79.9 | 5 |
| Ohio | $68.59 | $68.59 | $68.59 - $68.59 | 1 |
| Pennsylvania | $70.96 | $70.96 | $68.7 - $73.22 | 2 |
| Texas | $70.87 | $70.87 | $68.45 - $72.85 | 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 92597
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92597 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 |
| 97755 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 97755 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 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 |
Frequently Asked Questions, CPT 92597
What does CPT code 92597 mean? +
CPT code 92597 represents: Oral speech device eval. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92597? +
The 2026 Medicare national average non-facility payment for CPT 92597 is $73.17. Rates range from $66.68 to $93.3 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92597? +
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 92597? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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