Cochlear Implant Cost: What Medicare and Medicaid Pay

What does Medicare pay the hospital or surgery center?

The national payment rate for the facility is $33,686.28 in a hospital outpatient department, or $29,768.66 in an ambulatory surgical center, for surgery code 69930. Both are national rates from CMS files effective October 1, 2026.

• Hospital outpatient (OPPS Addendum B): status indicator J1, APC 5166, national payment rate $33,686.28.
• Ambulatory surgical center (ASC rate file): payment indicator J8, national payment rate $29,768.66, flagged device-intensive.

The two rates belong to different settings, and a surgery takes place in one of them. The table therefore shows them side by side and never adds them. They are national unadjusted rates, not the price a given hospital charges. The hospital row also prints patient copayment fields; those are read on does Medicare cover cochlear implants.

What is the surgeon's professional amount?

The surgeon's national amount for 69930 is $1,059.81, in the facility setting. It comes from the 2026 Physician Fee Schedule relative value file, in its edition effective October 1, 2026:

• work 17.29, practice expense 11.90 and malpractice 2.54 relative value units;
• a facility total of 31.73 units;
• a conversion factor of 33.4009.

The dollar amount is our product of the total units and the conversion factor, at national values. No non-facility amount is published for this code, so that cell is empty. This fee pays the surgeon's service. It is billed apart from the facility payment, and this page keeps the two apart.

What do implant programming visits pay?

The four programming codes tracked here, 92601 through 92604, each carry a non-facility and a facility amount in the same 2026 file:

• 92601: $154.31 non-facility, $98.20 facility.
• 92602: $97.20 non-facility, $55.78 facility.
• 92603: $145.63 non-facility, $95.86 facility.
• 92604: $87.51 non-facility, $53.44 facility.

Each amount uses the same conversion factor of 33.4009. CPT descriptions are left out, because we hold no documented permission to reuse them; match the code number on a bill against the table. The rows are per code, not a visit plan, so they are never summed into a total.

Pediatric cochlear implant cost: the codes for young children and Medicaid's EPSDT benefit

The programming codes split by age. West Virginia Medicaid's code listing describes 92601 and 92602 for a patient younger than 7, and 92603 and 92604 for age 7 or older. For a child under 7, the Medicare schedule amounts are $154.31 non-facility and $98.20 facility for 92601, and $97.20 and $55.78 for 92602. They are national schedule figures, not a state Medicaid rate and not what a family owes.

For a child enrolled in Medicaid, the federal EPSDT benefit covers children under age 21. Medicaid.gov says EPSDT "requires Medicaid coverage of necessary diagnostic and treatment services, including further testing, eyeglasses, hearing aids, replacement batteries, and cochlear implants, even if the services are not covered for adults." The benefit is for "medically necessary services needed to correct and ameliorate health conditions", so whether a given child qualifies is decided under the state's program. This page calculates no eligibility and no amount owed.

What does Medicare's device fee schedule list by state?

The October 2026 DMEPOS fee schedule lists code L8614 by state. Its official HCPCS long descriptor reads: Cochlear device, includes all internal and external components. The table keeps the non-rural rows that carry a published amount. Five of them:

• Alabama: $23,437.87.
• California: $24,149.06.
• Idaho: $22,998.52.
• New York: $23,460.09.
• Texas: $23,695.45.

These are fee schedule cells, not retail prices, and a code's presence in the file establishes no coverage for a person. Amounts for processors and other parts are on cochlear implant processor replacement cost.

What did Medicaid pay for implant device codes, by year?

Medicaid amounts here are national totals paid on T-MSIS claim lines for two device codes, by year, from 2018 to 2024; 2024 is preliminary. Code L8619 carries the official descriptor “Cochlear implant, external speech processor and controller, integrated system, replacement”, and it has a published total in every year:

• 2018: $9,583,585.98 over 2,255 claim lines.
• 2019: $15,464,601.70 over 3,265 claim lines.
• 2020: $10,718,044.81 over 2,239 claim lines.
• 2021: $20,596,064.53 over 4,025 claim lines.
• 2022: $21,989,103.13 over 4,837 claim lines.
• 2023: $29,240,207.20 over 5,716 claim lines.
• 2024 (preliminary): $16,818,746.37 over 3,141 claim lines.

For the device code L8614, the extract holds two years: $1,023,678.61 over 45 claim lines in 2021 and $483,751.07 over 18 claim lines in 2023. The 2023 total sits in a single published provider row: one identified biller accounts for all of it, so it describes that biller's claims, not a national rate.

Each figure is a yearly total across its claim lines, so it is not the price of one implant, and we do not divide it into one. The source identifies the provider on each claim line, not where the patient lives, so these totals are not broken down by state. Amounts for other processor and part codes are on cochlear implant processor replacement cost.

Is there an invisible cochlear implant? What the FDA database shows

Search results for "invisible cochlear implant" point to fully implanted designs. The FDA's premarket approval (PMA) database, read on November 3, 2026, records which implant systems hold an approval, and it is narrower than those results suggest.

Under product code MCM, the cochlear implant code, the PMA records carry 5 applicant names: Cochlear Americas, Advanced Bionics, Med-El Corp., Advanced Bionics Corp. and Oticon Medical. Two base approvals hold many of the records: P970051, "Nucleus® 24 Cochlear Implant System", and P000025, "MED-EL COMBI 40+ COCHLEAR IMPLANT SYSTEM".

Envoy Medical, whose Acclaim implant appears in these results, is not among the MCM applicants, and no PMA record carried the trade name Acclaim on November 3, 2026. Envoy's records all sit under product code OAF, with trade names such as "Esteem® Totally Implantable Hearing System". A missing record does not prove that no such device exists or that none is under review; it means no approval was in the database that day.

Processors worn off the ear, by manufacturer

• Cochlear: the FDA approved the Kanso 2 Sound Processor on 2020-07-02 (supplement S193 to P970051) and two Kanso 3 Sound Processors on 2025-07-03 (S225). These FDA records do not describe how Kanso is worn, and cochlear.com bars automated reading, so we state no wearing style for it here.
• MED-EL: the RONDO 3 Audio Processor was approved on 2020-08-25 (S116 to P000025). MED-EL's US page says it "is worn completely off the ear".
• Advanced Bionics: a 2011-11-17 approval (S089 to P960058) covered "a new off-the-ear sound processor called Neptune".

These records show an FDA decision on each named device. They say nothing about hearing results. A replacement processor is billed under the external processor codes on cochlear implant processor replacement cost.

If your search was for an invisible hearing aid rather than an implant, our invisible hearing aids page lists the in-canal models and what their makers say about them.

Related pages

Medicare's criteria and the patient copayment fields are on does Medicare cover cochlear implants. Processor and parts amounts are on cochlear implant processor replacement cost, bone-anchored devices on BAHA hearing aids, and Medicaid rules for hearing aids on does Medicaid cover hearing aids.