How much does Medicare pay for CPT 92627?

Medicare allowed an average of $20.15 per service and paid $15.10 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $83.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92627?

Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes. It was billed 2,953 times to 1,220 Medicare beneficiaries by 63 providers in 2024.

Which specialty bills 92627 most?

Audiologist, with 2,664 services from 57 clinicians. Next are Otolaryngology.

CPT 92627

Evaluation of hearing function related to surgically implanted hearing device, each additional 15 minutes

$20.15Medicare-allowed amount per service, averaged across 2,953 services

Providers submitted

$83.13

Asking price, not received

Medicare allowed

$20.15

The fee schedule figure

Medicare paid

$15.10

Balance is patient coinsurance

Providers submitted an average of $83.13 for this code and Medicare allowed $20.15 — 4.1× 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 $15.10 (75%); the rest is the patient’s coinsurance and deductible.

Services: 2,953
Beneficiaries: 1,220
Providers billing it: 63
Total allowed: $59,503

What Medicare pays for CPT 92627

Across 2,953 services billed by 63 providers to 1,220 beneficiaries, Medicare allowed an average of $20.15 per service. That is 2.4 services per beneficiary, so this is a code patients typically receive more than once. 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 92627

Specialty	Services	Beneficiaries	Avg allowed	Providers
Audiologist	2,664	1,111	$20.29	57
Otolaryngology	289	109	$18.81	6

92627 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
California	508	$21.83	$14.82	7
Texas	375	$19.98	$15.47	9
Oklahoma	303	$18.92	$14.69	5
Tennessee	295	$18.80	$15.67	4
New York	152	$22.95	$13.78	4
Florida	149	$20.73	$15.20	4
Missouri	139	$19.29	$14.65	4
Washington	134	$20.94	$13.33	2
Mississippi	134	$17.21	$15.87	1
Kentucky	133	$18.95	$14.52	3
South Carolina	113	$19.09	$15.51	3
Colorado	94	$20.51	$15.69	3
Ohio	74	$20.02	$15.88	2
Maryland	57	$20.92	$15.03	1
Oregon	50	$19.77	$14.95	2
Iowa	42	$18.98	$13.95	1
New Jersey	33	$22.31	$14.43	1
Pennsylvania	32	$21.38	$15.91	1
Idaho	29	$18.97	$15.39	1
Illinois	29	$21.23	$15.83	1
Alaska	24	$24.32	$15.26	1
New Mexico	22	$18.18	$12.45	1
South Dakota	20	$19.70	$13.50	1
North Carolina	12	$19.19	$14.65	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
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
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.