CPT 92616
Global XXX ActiveFees w/laryngeal sense test
CPT 92616 Billing & Documentation Guide
CPT code 92616 (Fees w/laryngeal sense test) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.83, a non-facility practice expense RVU of 4.95, and a malpractice RVU of 0.07, a total non-facility RVU of 6.85 and facility RVU of 2.39. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $236.92, though rates vary from $204.35 to $307.51 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92616, 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 92616 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 92616 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 92616
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.83 | 1.83 |
| Practice Expense RVU | 4.95 | 0.49 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 6.85 | 2.39 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92616
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 | $260.22 | $83.95 | $244.62 - $307.51 | 29 |
| Florida | $231.56 | $82.09 | $222.7 - $239.15 | 3 |
| Georgia | $221.74 | $79.63 | $211.39 - $232.09 | 2 |
| Illinois | $225.56 | $81.62 | $215.73 - $235.49 | 4 |
| Michigan | $219.66 | $79.79 | $214.71 - $224.61 | 2 |
| North Carolina | $216.87 | $77.89 | $216.87 - $216.87 | 1 |
| New York | $251.65 | $85.46 | $219.84 - $265.96 | 5 |
| Ohio | $214.43 | $78.42 | $214.43 - $214.43 | 1 |
| Pennsylvania | $226.12 | $80.21 | $215.11 - $237.13 | 2 |
| Texas | $226.4 | $79.75 | $213.75 - $238.24 | 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 92616
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92616 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 31575 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 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 | No | More extensive procedure |
| 69706 | Column 1 (primary), can be billed with modifier | No | More extensive procedure |
| 76120 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 76125 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92511 | Column 1 (primary), can be billed with modifier | No | More extensive procedure |
| 92520 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92610 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 92616
What does CPT code 92616 mean? +
CPT code 92616 represents: Fees w/laryngeal sense test. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92616? +
The 2026 Medicare national average non-facility payment for CPT 92616 is $236.92. Rates range from $204.35 to $307.51 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92616? +
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 92616? +
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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