CPT 92620
Global XXX ActiveAuditory function 60 min
CPT 92620 Billing & Documentation Guide
CPT code 92620 (Auditory function 60 min) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.5, a non-facility practice expense RVU of 1.14, and a malpractice RVU of 0.01, a total non-facility RVU of 2.65 and facility RVU of 1.92. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $91.15, though rates vary from $82.98 to $115.89 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92620, 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 92620 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 92620 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 92620
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.5 | 1.5 |
| Practice Expense RVU | 1.14 | 0.41 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 2.65 | 1.92 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92620
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 | $97.13 | $68.28 | $92.86 - $110.7 | 29 |
| Florida | $88.96 | $64.49 | $87.01 - $90.58 | 3 |
| Georgia | $86.9 | $63.64 | $84.46 - $89.34 | 2 |
| Illinois | $87.71 | $64.15 | $85.39 - $90.15 | 4 |
| Michigan | $86.32 | $63.43 | $85.24 - $87.41 | 2 |
| North Carolina | $85.84 | $63.09 | $85.84 - $85.84 | 1 |
| New York | $95.41 | $68.21 | $86.51 - $99.2 | 5 |
| Ohio | $85.2 | $62.94 | $85.2 - $85.2 | 1 |
| Pennsylvania | $88.21 | $64.33 | $85.37 - $91.04 | 2 |
| Texas | $88.17 | $64.17 | $85.06 - $90.78 | 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 92620
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92620 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 |
| 69209 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 69210 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92571 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92572 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92576 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92626 | 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 |
| 92506 | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92620
What does CPT code 92620 mean? +
CPT code 92620 represents: Auditory function 60 min. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92620? +
The 2026 Medicare national average non-facility payment for CPT 92620 is $91.15. Rates range from $82.98 to $115.89 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92620? +
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 92620? +
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 June 2, 2026.
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