CPT 92627
Global ZZZ ActiveEval aud funcj ea addl 15
CPT 92627 Billing & Documentation Guide
CPT code 92627 (Eval aud funcj ea addl 15) is classified under Audiology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.33, a non-facility practice expense RVU of 0.27, and a malpractice RVU of 0, a total non-facility RVU of 0.6 and facility RVU of 0.42. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $20.66, though rates vary from $18.77 to $26.14 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92627, 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 92627 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 6 units of 92627 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 92627
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.33 | 0.33 |
| Practice Expense RVU | 0.27 | 0.09 |
| Malpractice RVU | 0 | 0 |
| Total RVU | 0.6 | 0.42 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92627
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 | $22.09 | $14.97 | $21.09 - $25.24 | 29 |
| Florida | $20.07 | $14.04 | $19.64 - $20.41 | 3 |
| Georgia | $19.65 | $13.91 | $19.07 - $20.22 | 2 |
| Illinois | $19.78 | $13.97 | $19.26 - $20.36 | 4 |
| Michigan | $19.49 | $13.84 | $19.26 - $19.72 | 2 |
| North Carolina | $19.44 | $13.83 | $19.44 - $19.44 | 1 |
| New York | $21.61 | $14.9 | $19.59 - $22.45 | 5 |
| Ohio | $19.26 | $13.77 | $19.26 - $19.26 | 1 |
| Pennsylvania | $19.96 | $14.07 | $19.3 - $20.61 | 2 |
| Texas | $19.96 | $14.05 | $19.23 - $20.59 | 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 92627
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92627 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 |
| 92590 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 92591 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 92592 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 92593 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 92594 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 92595 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 92622 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92627
What does CPT code 92627 mean? +
CPT code 92627 represents: Eval aud funcj ea addl 15. It's in the Audiology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 92627? +
The 2026 Medicare national average non-facility payment for CPT 92627 is $20.66. Rates range from $18.77 to $26.14 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92627? +
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 92627? +
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 1, 2026.
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