How much does Medicare pay for CPT 92611?

Medicare allowed an average of $91.51 per service and paid $70.88 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $413.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92611?

Evaluation of swallowing function image. It was billed 10,215 times to 9,922 Medicare beneficiaries by 160 providers in 2024.

Does 92611 pay differently in an office than a hospital?

Yes. The allowed amount averaged $91.30 in an office setting and $97.61 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 92611 most?

Speech Language Pathologist, with 5,591 services from 92 clinicians. Next are Family Practice, Internal Medicine, Diagnostic Radiology.

CPT 92611

Evaluation of swallowing function image

$91.51Medicare-allowed amount per service, averaged across 10,215 services

Providers submitted

$413.37

Asking price, not received

Medicare allowed

$91.51

The fee schedule figure

Medicare paid

$70.88

Balance is patient coinsurance

Providers submitted an average of $413.37 for this code and Medicare allowed $91.51 — 4.5× 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 $70.88 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $91.30
Hospital / facility: $97.61

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 9,889 services were billed in an office setting and 326 in a facility.

Services: 10,215
Beneficiaries: 9,922
Providers billing it: 160
Total allowed: $934,775

What Medicare pays for CPT 92611

Across 10,215 services billed by 160 providers to 9,922 beneficiaries, Medicare allowed an average of $91.51 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 92611

Specialty	Services	Beneficiaries	Avg allowed	Providers
Speech Language Pathologist	5,591	5,403	$91.81	92
Family Practice	1,088	1,072	$92.06	11
Internal Medicine	861	845	$89.89	9
Diagnostic Radiology	403	391	$96.99	8
General Practice	315	308	$89.63	4
Emergency Medicine	281	268	$90.68	3
Obstetrics & Gynecology	268	263	$87.11	5
Otolaryngology	222	212	$88.56	8
Nurse Practitioner	185	182	$77.65	5
Physical Medicine and Rehabilitation	178	161	$94.36	3
Pathology	151	150	$94.61	1
Pediatric Medicine	111	108	$92.82	2
Ophthalmology	91	90	$89.53	1
Anesthesiology	90	90	$88.82	1
Cardiology	82	82	$99.55	1

92611 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
Texas	2,119	$90.84	$70.90	24
Minnesota	1,356	$91.45	$68.09	20
California	1,048	$97.90	$67.83	18
Florida	935	$87.62	$68.67	17
Arizona	896	$88.38	$68.75	9
Massachusetts	739	$96.13	$71.41	6
New York	669	$102.66	$69.52	10
Indiana	281	$88.05	$70.91	5
Ohio	216	$87.42	$71.86	3
Illinois	210	$86.79	$66.75	5
Tennessee	208	$83.26	$70.31	3
Wisconsin	150	$86.88	$67.22	3
Oklahoma	148	$84.94	$71.84	1
Arkansas	142	$81.75	$68.33	2
Pennsylvania	136	$87.42	$67.73	5
Mississippi	105	$90.40	$71.04	1
New Jersey	95	$101.54	$69.23	3
Georgia	86	$91.15	$67.26	3
Utah	84	$89.78	$70.99	2
Kansas	83	$85.55	$66.47	4
Nevada	72	$89.99	$69.99	2
North Carolina	63	$85.93	$68.58	2
Louisiana	62	$84.93	$71.93	3
Michigan	60	$77.13	$60.94	1
Nebraska	57	$93.70	$71.89	1
Connecticut	45	$95.32	$71.60	1
Colorado	38	$93.05	$71.81	1
Washington	34	$91.71	$71.79	1
Missouri	24	$91.77	$62.78	1
Iowa	23	$85.44	$66.00	1
New Mexico	16	$86.46	$67.53	1
South Carolina	15	$86.00	$67.19	1

Related codes

92610Evaluation of swallowing function$85.94
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
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.