CPT code 92626 represents a clinician-performed auditory functional status evaluation lasting the first or only hour. The assessment evaluates sound perception, listening ability, orienting movements, and balance to determine candidacy for surgically implanted hearing devices or to assess the performance of an existing implant. Nationally, this code is important for care pathways linking diagnostic audiology to device-based interventions and for appropriate billing of specialized auditory evaluations.

This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical intent and typical sites of service for CPT code 92626, commonly associated billing modifiers (listed separately), and the payer scope addressed. The publication summarizes benchmarks related to use and payment patterns where available, highlights relevant policy or coverage considerations affecting implant candidacy assessments, and provides clinical context to inform coding accuracy and documentation needs.

The content is targeted to health policy analysts, coding professionals, and clinical managers seeking a concise summary of CPT code 92626’s role in the diagnostic and pre- or post-implantation workflow. Data not available in the input is noted where applicable.