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    v1.0.30
    OpenPayerBilling CodesEvaluative and Therapeutic Otorhinolaryngologic ServicesCPT cpt-92611-endoscopic-cine-video-swallowing-study
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    CPT 92611: Videofluoroscopic Swallowing Study (Cine/Video)

    Medicare pays $95 and commercial payers pay $193 on average nationally for this procedure.

    CPT code 92611 describes a videofluoroscopic study of the oral cavity, pharynx, larynx, and esophagus using cine or video recording to assess a patient’s swallowing function; service type: diagnostic swallowing study; typical site of service: radiology suite or hospital imaging department where fluoroscopic swallowing examinations are performed.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

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    National Reimbursement Benchmarks

    Nationally, Medicare’s mean allowed rate for CPT 92611 is $94.6, versus BUCA’s commercial average of $193.5 — a gap of $98.9, with BUCA roughly double Medicare on average. Blue Cross Blue Shield and Aetna present higher mean levels ($237.6 and $96.5 respectively) and wider tails, while UnitedHealth Group and Cigna sit between those extremes; this frames a commercial landscape where contract positioning can materially affect reimbursement relative to the Medicare baseline.

    Dispersion measured as the interquartile range (P75–P25) highlights variability: Blue Cross Blue Shield has the widest IQR at $121.0 ($287.7–$186.7), followed by Cigna at $110.8 ($201.3–$98.2) and UnitedHealth Group at $88.9 ($186.2–$97.3). Aetna’s IQR is $33.7 ($108.2–$75.0), the tightest among payers with full quartile data, while BUCA’s IQR is $90.0 ($235.2–$145.4) and Medicare’s IQR is $8.0 ($97–$89). These ranges signal which payers exhibit more concentrated versus more dispersed commercial pricing.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with progressive coughing and choking during meals is referred by their primary care physician to evaluate swallowing safety. The patient reports recent weight loss and recurrent aspiration pneumonia. A speech-language pathologist performs a clinical bedside assessment and determines that instrumental evaluation is required. The clinician schedules a videofluoroscopic swallow study (VFSS) coded as 92611 to visualize oral, pharyngeal, and esophageal phases of swallowing using cine/video radiography.

    On the day of service, the patient arrives to a radiology fluoroscopy suite or an outpatient radiology center. The exam is performed with interdisciplinary participation: a speech-language pathologist administers standardized bolus trials (varied consistencies and volumes) while a radiologist and radiologic technologist operate cineradiography equipment. Contrast material (barium or suitable contrast) is given in measured amounts. Real-time cine/video recording documents bolus transit, airway protection, and any aspiration events. Findings guide immediate therapeutic recommendations such as dietary modification, compensatory maneuvers, and need for further evaluation. A formal report is generated by the interpreting clinician and a separate therapy report documents functional recommendations and follow-up plans.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    74230Radiologic examination, swallowing function, with cineradiography/videoradiography (interpreting physician/radiologist portion)

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    96Modifier 96 is appended to CPT codes to indicate that a service or procedure was provided for habilitative purposes — i.e., to help a patient learn, maintain, or improve skills and functioning for…- Use modifier -96 when a procedure or service that could be either habilitative or rehabilitative is provided specifically for habilitative purposes — i.e., to help a patient learn, maintain, or…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    171400000X
    103TC1900X
    2278G0305X
    204E00000X
    2278H0200X
    208000000X
    103TH0004X
    251K00000X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    F52.0Hypoactive sexual desire disorder
    G51.8Other disorders of facial nerve
    G51.9Disorder of facial nerve, unspecified
    I69.391Dysphagia following cerebral infarction
    I69.398Other sequelae of cerebral infarction
    J69.0Pneumonitis due to inhalation of food and vomit
    J69.1Pneumonitis due to inhalation of oils and essences
    J69.8Pneumonitis due to inhalation of other solids and liquids
    K21.9Gastro-esophageal reflux disease without esophagitis
    K22.0Achalasia of cardia

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-92601-COCHLEAR-IMPLANT-ANALYSIS-PROGRAMMING-UNDER-7

    CPT 92601: Cochlear Implant Analysis and Programming, Patient <7

    CPT-92602-COCHLEAR-IMPLANT-REPROGRAMMING-PEDIATRIC

    CPT 92602: Cochlear Implant Reprogramming, Patient <7 Years

    CPT-92603-COCHLEAR-IMPLANT-ANALYSIS-AND-PROGRAMMING

    CPT 92603: Cochlear Implant Programming and Patient Counseling

    CPT-92604-COCHLEAR-IMPLANT-REPROGRAMMING

    CPT 92604: Cochlear Implant Reprogramming, Age 7 and Older

    CPT-92605-AAC-DEVICE-EVALUATION-ONE-HOUR

    CPT 92605: Evaluation for Non–Speech–Generating Communication Device

    CPT-92606-ASSISTIVE-COMMUNICATION-DEVICE-TRAINING-CAREGIVER-INSTRUCTION

    CPT 92606: Therapeutic Training for Non‑Speech Generating Device

    CPT-92607-SPEECH-GENERATING-DEVICE-EVALUATION-FIRST-HOUR

    CPT 92607: Evaluation for Speech‑Generating Device, First Hour

    CPT-92608-SPEECH-GENERATING-DEVICE-ADDITIONAL-30-MIN-EVAL

    CPT 92608: Additional 30-Minute Speech‑Generating Device Evaluation

    CPT-92609-SPEECH-GENERATING-DEVICE-THERAPY-CAREGIVER-TRAINING

    CPT 92609: Therapeutic Training for Speech‑Generating Device

    CPT-92610-SPECIAL-OTORHINOLARYNGOLOGIC-PROCEDURE-SWALLOWING-EVALUATION

    CPT 92610: Special Otolaryngologic Procedure for Swallowing Evaluation

    Showing 1–10 of 37

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Imaging counterpart that may be billed by the interpreting radiologist when separation of professional and technical components occurs alongside 92611.
    92610Evaluation of oral and pharyngeal swallowing functionClinical/behavioral evaluation by a speech-language pathologist that often precedes or complements 92611.
    92612Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recordingAlternative instrumental swallowing evaluation (FEES) that may be used instead of or in sequence with 92611 depending on clinical needs.