CPT 92610
Global XXX ActiveEvaluate swallowing function
CPT 92610 Billing & Documentation Guide
CPT code 92610 (Evaluate swallowing function) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.3, a non-facility practice expense RVU of 1.23, and a malpractice RVU of 0.01, a total non-facility RVU of 2.54 and facility RVU of 1.73. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $87.47, though rates vary from $78.88 to $109.07 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92610, 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 92610 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 92610 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 92610
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.3 | 1.3 |
| Practice Expense RVU | 1.23 | 0.42 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 2.54 | 1.73 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92610
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 | $93.77 | $61.76 | $89.37 - $107.62 | 29 |
| Florida | $85.29 | $58.15 | $83.2 - $87.03 | 3 |
| Georgia | $83.08 | $57.27 | $80.47 - $85.69 | 2 |
| Illinois | $83.91 | $57.77 | $81.45 - $86.51 | 4 |
| Michigan | $82.47 | $57.07 | $81.31 - $83.63 | 2 |
| North Carolina | $81.97 | $56.72 | $81.97 - $81.97 | 1 |
| New York | $91.77 | $61.58 | $82.68 - $95.67 | 5 |
| Ohio | $81.27 | $56.57 | $81.27 - $81.27 | 1 |
| Pennsylvania | $84.41 | $57.91 | $81.45 - $87.37 | 2 |
| Texas | $84.42 | $57.78 | $81.12 - $87.27 | 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 92610
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92610 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 |
| 69705 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 69706 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 92511 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 92611 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 92612 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 92613 | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 92614 | Column 2 (secondary), bundled into primary | Yes | Mutually exclusive procedures |
Frequently Asked Questions, CPT 92610
What does CPT code 92610 mean? +
CPT code 92610 represents: Evaluate swallowing function. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92610? +
The 2026 Medicare national average non-facility payment for CPT 92610 is $87.47. Rates range from $78.88 to $109.07 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92610? +
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 92610? +
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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