Summary & Overview
CPT 92627: Extended Auditory Functional Status Evaluation
CPT code 92627 represents an extended, time-based component of an auditory functional status evaluation, billed for each additional 15 minutes after the initial hour when assessing sound perception, listening ability, orienting movements, and balance. This code is applied in clinical workflows that evaluate candidates for surgically implanted hearing devices and monitor the performance of existing implants. Nationally, use of 92627 affects specialty outpatient audiology and otolaryngology billing and can influence resource allocation for implant candidacy pathways and post-implant follow-up care.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose of the code, typical sites of service, common modifiers associated with this service (listed separately), and the policy and billing contexts that shape reimbursement and documentation expectations. The publication provides benchmarks and coding guidance context, highlights common billing scenarios for extended auditory evaluations, and summarizes clinical implications for implant candidacy assessments and follow-up efficacy testing. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 92627 describes an auditory functional status evaluation performed by a qualified provider to assess sound perception, listening ability, orienting movements, and balance. This service is used to determine candidacy for a surgically implanted hearing device or to evaluate the effectiveness of a previously implanted hearing device. The code specifically represents each additional 15 minutes of evaluation time after the first hour of service.
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Service type: Extended auditory functional status evaluation (additional time-based unit)
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Typical site of service: Audiology clinics, otolaryngology practices, specialized hearing implant centers, or other outpatient settings where device candidacy and implant follow-up evaluations are performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with long-standing bilateral sensorineural hearing loss and poor benefit from conventional hearing aids is evaluated in a tertiary otology clinic as a candidate for a surgically implanted hearing device (e.g., cochlear implant or bone-anchored hearing system). The clinical workflow begins with review of prior audiology records and a focused history of hearing difficulties, device use, and medical/surgical contraindications. The provider performs a comprehensive auditory functional status evaluation that extends beyond 60 minutes to assess sound perception, speech recognition in quiet and noise, localization/orienting movements, and balance-related vestibular screening relevant to surgical candidacy and device programming. Testing may include aided and unaided pure-tone thresholds, aided speech perception testing, real-ear measures, listening performance with trial processors, and assessment of vestibular symptoms that could affect implantation.
During the same visit the team documents prior implanted device performance (if present), compares objective aided measures and speech scores, and determines candidacy for implantation or need for device reprogramming or revision. The extended evaluation time represented by 92627 is billed in 15-minute increments after the first hour when testing and interpretation require additional time for complex cases, bilateral assessments, or when coordination with audiology and implant programming is necessary. Typical sites of service include outpatient otolaryngology or audiology clinics within hospital outpatient departments and specialized implant centers.
Coding Specifications
| Modifier | Description | When to Use |
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