CPT code 92504: Ear microscopy, binocular diagnostic examination2026 Medicare rate & RVUs in South Dakota

Reports a binocular-microscope examination of the ear canal and eardrum when magnified inspection provides a distinct diagnostic assessment beyond routine otoscopy.

CMS RVU26DEffective Oct 1, 2026One payment locality257.8K Medicare services in 2024

In South Dakota, Medicare pays $28.50 for 92504 in the office and $7.46 when it’s performed in a hospital or facility.

$28.50Office (non-facility)
$7.46Hospital or facility
−0.8%vs the national office rate ($28.72)

Check a contract rate as a % of Medicare · 92504 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 92504 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 92504 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 92504 covers

An otolaryngologist typically uses a binocular microscope to inspect the external ear canal and tympanic membrane in an office or other clinical setting. Magnification can help assess findings such as canal inflammation, debris, a suspected perforation, or the position of a tympanostomy tube. The service is a diagnostic examination, not simply the use of a microscope as a visual aid during another procedure.

Select this code when the clinician performs and documents a distinct microscopic ear assessment. Record the ear or ears examined, the relevant findings, and how the examination informs the clinical assessment or plan. Routine otoscopy alone does not support this service, and microscope use solely to perform cerumen removal or another procedure should not be treated as a separate diagnostic examination. CMS physician fee schedule valuation accounts for work, practice expense, and malpractice inputs, with practice expense values differing between office and facility settings.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How South Dakota compares for 92504

Across 109 of 109 payment localities, the office rate for 92504 runs from $25.41 in Arkansas to $39.12 in San Benito County, CA. South Dakota pays $28.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

92504 in South Dakota vs other payment areas
  1. South Dakota · this page$28.50
  2. Los Angeles, CA · California$32.95+$4.45
  3. Washington, DC area · District of Columbia$33.07+$4.57
  4. Miami, FL · Florida$30.15+$1.65
  5. Chicago, IL · Illinois$29.31+$0.81
  6. Manhattan, NY · New York$32.93+$4.43
  7. Alaska · Alaska$33.04+$4.54

Other areas in South Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

92504 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$25.78$7.37
ArkansasArkansas$25.41$7.33
ArizonaArizona$27.98$7.59
Bakersfield, CACalifornia$30.86$7.79
Chico, CACalifornia$30.82$7.76
El Centro, CACalifornia$30.82$7.76
Fresno, CACalifornia$30.82$7.76
Hanford, CACalifornia$30.82$7.76

92504 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$25.41

$34.97

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92504 office rate range by state
State / territoryOffice rate rangeLocalities
AK$33.041
AL$25.781
AR$25.411
AZ$27.981
CA$30.82–$39.1229
CO$30.161
CT$30.641
DC$33.071
DE$28.451
FL$27.91–$30.153
GA$26.37–$29.172
GU$31.651
HI$31.651
IA$26.621
ID$26.761
IL$26.97–$29.634
IN$26.921
KS$26.411
KY$26.211
LA$26.14–$27.452
MA$29.94–$33.282
MD$29.03–$33.073
ME$26.81–$28.402
MI$26.82–$28.172
MN$29.141
MO$25.63–$27.653
MS$25.531
MT$28.721
NC$27.101
ND$28.531
NE$26.791
NH$29.601
NJ$31.06–$32.712
NM$26.931
NV$28.691
NY$27.51–$33.635
OH$26.781
OK$26.261
OR$28.54–$31.222
PA$26.87–$29.812
PR$28.971
RI$29.541
SC$26.971
SD$28.501
TN$26.531
TX$26.69–$30.008
UT$27.351
VA$28.25–$33.072
VI$28.971
VT$28.341
WA$29.91–$34.042
WI$27.551
WV$25.941
WY$28.641

See 92504 in every payment locality

How the 92504 rate is calculated

Each of 92504’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 92504

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.67

0.67 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.8600

Conversion factor

$33.4009

Medicare rate

$28.72

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,778

Code
92504
Physician work
0.18
Practice expense
0.67
Malpractice
0.01

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 92504 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0000.1800
Practice expense0.67× 1.0000.6700
Malpractice0.01× 0.3360.0034
Total RVUs0.8534
Conversion factor× 33.4009

Office rate, South Dakota$28.50

Office: (0.18 × 1 + 0.67 × 1 + 0.01 × 0.336) × $33.4009 = $28.50

Facility: (0.18 × 1 + 0.04 × 1 + 0.01 × 0.336) × $33.4009 = $7.46

Open 92504 in the RVU calculator

Payment rules and modifiers for 92504

92504 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 92504

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$28.72

Non-facility (office)
$28.72
Facility
$7.68

Higher because the practice carries its own overhead.

How 92504 has changed in South Dakota

92504 · Office / nonfacility

$28.50

Effective 2026-10-01

The base rate is $0.88 higher than on 2025-10-01, moving from $27.62 to $28.50 (3.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $27.62changed to$28.50

    • Conversion factor 32.3465 changed to 33.4009
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $28.75changed to$27.62

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.68 changed to 0.67

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $28.29changed to$28.75

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $29.27changed to$28.29

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $29.54changed to$29.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.67 changed to 0.68
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $29.78changed to$29.54

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $29.37changed to$29.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.63 changed to 0.67
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $29.69changed to$29.37

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.64 changed to 0.63
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $29.66changed to$29.69

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $29.93changed to$29.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.65 changed to 0.64
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $30.22changed to$29.93

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.66 changed to 0.65
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $30.33changed to$30.22

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $30.18changed to$30.33

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $30.24changed to$30.18

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $31.45changed to$30.24

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.74 changed to 0.66
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $31.45

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$28.50$7.46RVU26D
2026-07-01$28.50$7.46RVU26C
2026-04-01$28.50$7.46RVU26B
2026-01-01$28.50$7.46RVU26A
2025-10-01$27.62$8.86RVU25D
2025-07-01$27.62$8.86RVU25C
2025-04-01$27.62$8.86RVU25B
2025-01-01$27.62$8.86RVU25A
2024-10-01$28.75$8.78RVU24D
2024-07-01$28.75$8.78RVU24C
2024-04-01$28.75$8.78RVU24B
2024-03-09$28.75$8.78RVU24AR
2024-01-01$28.29$8.64RVU24A
2023-10-01$29.27$9.27RVU23D
2023-07-01$29.27$9.27RVU23C
2023-04-01$29.27$9.27RVU23B
2023-01-01$29.27$9.27RVU23A
2022-10-01$29.54$9.12RVU22D
2022-07-01$29.54$9.12RVU22C
2022-04-01$29.54$9.12RVU22B
2022-01-01$29.54$9.12RVU22A
2021-10-01$29.78$9.19RVU21D
2021-07-01$29.78$9.19RVU21C
2021-04-01$29.78$9.19RVU21B
2021-01-01$29.78$9.19RVU21A
2020-10-01$29.37$9.52RVU20D
2020-07-01$29.37$9.52RVU20C
2020-04-01$29.37$9.52RVU20B
2020-01-01$29.37$9.52RVU20A
2019-10-01$29.69$9.51RVU19D
2019-07-01$29.69$9.51RVU19C
2019-04-01$29.69$9.51RVU19B
2019-01-01$29.69$9.51RVU19A
2018-10-01$29.66$9.50RVU18D
2018-07-01$29.66$9.50RVU18C
2018-04-01$29.66$9.50RVU18B
2018-01-01$29.66$9.50RVU18AR1
2017-10-01$29.93$9.47RVU17D
2017-07-01$29.93$9.47RVU17C
2017-04-01$29.93$9.47RVU17B
2017-01-01$29.93$9.47RVU17A
2016-10-01$30.22$9.45RVU16D
2016-07-01$30.22$9.45RVU16C
2016-04-01$30.22$9.45RVU16B
2016-01-01$30.22$9.45RVU16A
2015-10-01$30.33$9.49RVU15D
2015-07-01$30.33$9.49RVU15C
2015-04-01$30.18$9.44RVU15B
2015-01-01$30.18$9.44RVU15A
2014-10-01$30.24$9.46RVU14D
2014-07-01$30.24$9.46RVU14C
2014-04-01$30.24$9.46RVU14B
2014-01-01$30.24$9.46RVU14A
2013-10-01$31.45$9.33RVU13D
2013-07-01$31.45$9.33RVU13C
2013-04-01$31.45$9.33RVU13B
2013-01-01$31.45$9.33RVU13AR

Price 92504 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

92504 billing questions

When is microscopic examination distinct from routine otoscopy?

Report 92504 when the clinician performs a diagnostic examination using binocular magnification and documents the findings. A routine look with an otoscope during an E/M visit is not the same service.

Can 92504 be reported with an office E/M service?

It may be reported with an E/M service when both are performed and the record supports a distinct microscopic examination as well as the separately documented E/M work.

Should 92504 be used when impacted cerumen is removed?

Choose the cerumen-removal code when removal is the service performed. Do not report 92504 merely because the microscope helps visualize that removal.

How does 92504 differ from 92502?

92504 describes diagnostic microscopic examination of the ear. 92502 is for an otolaryngologic examination performed under general anesthesia.

What documentation supports 92504?

Document use of binocular microscopy, the ear findings, and the diagnostic purpose of the examination. Identify the side or sides examined in the note.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 92504PPRRVU2026_Oct_nonQPP.csv, line 11,778 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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