CPT 92625

Understanding CPT Code 92625: Tinnitus Assessment

CPT code 92625 is the diagnostic workup for tinnitus — your audiologist measures the pitch and loudness of the ringing or buzzing you hear and tests how it can be masked. The results guide treatment options like sound therapy, hearing aids with tinnitus features, or referral for further evaluation.

What Medicare Pays vs. What You Might Be Charged
Category Amount
Medicare Allowed Rate What Medicare approves for this service $66.86
Typical Billed Amount What providers commonly charge $100 – $300
Potential Markup How much more you might pay vs. Medicare rate ~250% above Medicare
Why the difference? Providers set their own prices. Without insurance, you may be billed the full amount. Even with insurance, your co-pay is often based on the provider's charge — not the Medicare rate.

What CPT 92625 Means and When It's Used

CPT code 92625 covers the diagnostic tinnitus assessment. Your audiologist plays tones at varying pitches into the ear and asks you to identify which one most closely matches the ringing, buzzing, or hissing you hear. They then measure how loud that tone needs to be (loudness match) and how much sound is needed to make your tinnitus less noticeable (minimum masking level). The combination quantifies what until then has been a purely subjective complaint.

You'll see 92625 used when tinnitus is the primary complaint and the patient is being evaluated for treatment options — sound therapy, tinnitus-masker hearing aids, cognitive behavioral therapy referral, or further medical workup for treatable causes. It's almost always paired with a comprehensive hearing test (CPT 92557), since tinnitus and hearing loss frequently coexist.

92625 is the foundation for any objective tracking of tinnitus over time. If you're starting a treatment, your audiologist may repeat the assessment after several months to measure whether the loudness or masking level has changed.

Understanding Your Bill for CPT 92625

Charges for CPT 92625 typically range from $100 to $300. Medicare's national allowed amount is approximately $66.86. The test itself takes around 20-30 minutes, longer than most audiology codes.

92625 is rarely billed alone — it usually appears with 92557 (comprehensive audiometry) and sometimes 92587 or 92588 (OAE testing) to rule out specific inner-ear contributions. Make sure each test on your bill matches what was actually performed during the visit.

Original Medicare covers 92625 when ordered by a physician for diagnostic evaluation. Coverage by commercial insurance varies — some plans treat tinnitus assessment as covered medical care, others classify it under audiology benefits with separate limits.

How to Verify Your CPT 92625 Charges

The tinnitus assessment is distinctive. If your audiologist asked you to compare a test tone to your tinnitus, adjusted the pitch and loudness, and measured masking levels, you had a 92625. If the conversation was only a brief discussion of your tinnitus during a regular hearing test, no separate 92625 should be billed.

Watch for 92625 billed alongside 92557 when only one was actually performed. The two codes describe distinct procedures, and a comprehensive hearing test alone — even one that mentions tinnitus — does not justify billing 92625.

If your insurance denies the claim as not medically necessary, ask the provider what diagnostic ICD-10 code was attached. H93.19 (tinnitus) is the most common, but the specific subcode matters for coverage.

Billing alert: A 92625 should reflect a distinct tinnitus measurement procedure — not just a discussion of tinnitus during a regular hearing test. If you weren't asked to match a test tone to your tinnitus, ask whether 92625 was correctly billed.

Codes Often Confused With CPT 92625

CPT 92557 CPT 92567 CPT 92587 CPT 92626

This billing code often appears alongside these diagnosis codes on insurance claims:

H93.19
Tinnitus
H91.90
Hearing Loss, Unspecified
H81.09
Meniere Disease
H90.71
Mixed Hearing Loss

Browse all diagnosis codes →

Frequently Asked Questions

CPT 92625 typically costs between $100–$300, with Medicare's national allowed amount around $66.86. The assessment usually takes 20-30 minutes and is often billed alongside a comprehensive hearing test (CPT 92557).
Original Medicare covers 92625 when a physician orders it to evaluate tinnitus. Many Medicare Advantage plans include hearing benefits that cover it as well. Coverage by commercial insurance varies — some plans require prior authorization.
The audiologist plays tones at different pitches and asks which most closely matches your tinnitus (pitch match), measures how loud that tone needs to be (loudness match), and tests how much external sound is needed to mask the tinnitus. The whole assessment usually takes 20-30 minutes.

Related Diagnosis Codes

These ICD-10 diagnosis codes are commonly paired with CPT 92625 on medical bills:

H93.19 — Tinnitus H91.90 — Hearing Loss H81.09 — Meniere Disease H90.71 — Mixed Hearing Loss

Sources