How much does Medicare pay for CPT 92610?

Medicare allowed an average of $85.94 per service and paid $66.84 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $281.84, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92610?

Evaluation of swallowing function. It was billed 25,319 times to 22,273 Medicare beneficiaries by 810 providers in 2024.

Does 92610 pay differently in an office than a hospital?

Yes. The allowed amount averaged $86.22 in an office setting and $74.87 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 92610 most?

Speech Language Pathologist, with 22,906 services from 742 clinicians. Next are Otolaryngology, Neurology, Nurse Practitioner.

CPT 92610

Evaluation of swallowing function

$85.94Medicare-allowed amount per service, averaged across 25,319 services

Providers submitted

$281.84

Asking price, not received

Medicare allowed

$85.94

The fee schedule figure

Medicare paid

$66.84

Balance is patient coinsurance

Providers submitted an average of $281.84 for this code and Medicare allowed $85.94 — 3.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $66.84 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $86.22
Hospital / facility: $74.87

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 24,691 services were billed in an office setting and 628 in a facility.

Services: 25,319
Beneficiaries: 22,273
Providers billing it: 810
Total allowed: $2,175,915

What Medicare pays for CPT 92610

Across 25,319 services billed by 810 providers to 22,273 beneficiaries, Medicare allowed an average of $85.94 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 92610

Specialty	Services	Beneficiaries	Avg allowed	Providers
Speech Language Pathologist	22,906	20,170	$86.35	742
Otolaryngology	1,212	994	$84.77	28
Neurology	328	261	$89.16	14
Nurse Practitioner	200	197	$71.68	6
Diagnostic Radiology	157	157	$75.26	2
Internal Medicine	150	148	$72.05	4
Pulmonary Disease	114	114	$82.58	8
Physical Medicine and Rehabilitation	96	88	$74.41	3
Unknown Supplier/Provider Specialty	65	59	$83.34	1
Interventional Pain Management	62	62	$84.41	1
Physician Assistant	29	23	$67.25	1

92610 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	5,533	$92.64	$64.05	136
Florida	2,466	$82.16	$64.76	67
New Jersey	1,836	$90.64	$65.75	74
Pennsylvania	1,536	$85.22	$65.85	52
Minnesota	1,436	$85.89	$64.15	21
California	1,185	$91.29	$65.29	40
South Carolina	888	$80.18	$64.93	36
Arizona	884	$82.09	$64.81	12
Virginia	855	$84.41	$65.76	35
Maryland	648	$87.06	$65.35	26
Illinois	561	$82.14	$63.88	29
Texas	519	$83.31	$64.02	24
Washington	503	$83.03	$65.61	12
Georgia	471	$81.71	$65.02	17
Missouri	400	$81.29	$64.24	15
Ohio	382	$80.17	$65.80	15
Oklahoma	377	$74.35	$62.18	9
Nevada	353	$83.38	$64.45	6
Michigan	352	$81.80	$58.39	6
Wisconsin	338	$80.88	$65.97	10
Tennessee	312	$78.71	$64.30	14
Massachusetts	308	$89.93	$62.95	13
North Carolina	281	$82.12	$65.75	14
Delaware	235	$85.79	$66.37	8
Oregon	194	$84.35	$63.51	5
Indiana	192	$78.01	$63.49	10
Arkansas	192	$76.38	$63.16	6
Kansas	191	$79.32	$64.74	6
Colorado	189	$85.21	$64.90	12
Iowa	186	$80.50	$65.27	11
Nebraska	184	$79.35	$65.60	10
Maine	178	$82.27	$65.99	6
Alabama	129	$77.82	$62.66	5
Connecticut	124	$89.54	$64.49	7
Louisiana	121	$79.35	$64.67	6
Utah	119	$79.74	$64.47	7
Hawaii	89	$88.48	$60.75	2
New Hampshire	78	$85.32	$65.66	3
Rhode Island	76	$87.15	$65.63	3
Kentucky	73	$79.18	$64.27	4
New Mexico	68	$78.68	$62.72	3
Mississippi	61	$77.53	$64.73	3
South Dakota	58	$82.69	$63.26	2
District of Columbia	49	$89.97	$66.72	3
Alaska	43	$107.43	$64.98	2
Idaho	27	$75.39	$60.35	1
Wyoming	20	$83.48	$64.94	1
West Virginia	19	$79.86	$66.57	1

Related codes

92604Analysis and reprogramming of inner ear implant (7 years or older)$85.74
92653Evaluation of brain response to sound for diagnosis of nervous system$83.07
92626Evaluation of hearing function related to surgically implanted hearing$83.86
92611Evaluation of swallowing function image$91.51
92609Therapy service for use of speech-generating device$104.52
92625Evaluation of hearing ringing in ear$67.08
92612Evaluation and recording of swallowing$195.12
92652Evaluation of brain response to sound for determination of hearing thr$112.41
92613Evaluation, recording, and interpretation of swallowing using an endos$37.04
92627Evaluation of hearing function related to surgically implanted hearing$20.15
92616Evaluation and recording of swallowing and voice box sensory function$198.20
92620Evaluation of hearing function brain responses$88.68

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.