CPT code 92504: Ear microscopy, binocular diagnostic examination2026 Medicare rate & RVUs in Houston, TX

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 Houston, TX, Medicare pays $28.74 for 92504 in the office and $7.85 when it’s performed in a hospital or facility.

$28.74Office (non-facility)
$7.85Hospital or facility
+0.1%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $28.74. The RVUs are the same everywhere; the geographic indexes change the dollars.

92504 in Houston, TX vs other payment areas
  1. Houston, TX · this page$28.74
  2. Austin, TX · Texas$30.00+$1.26
  3. Beaumont, TX · Texas$26.69−$2.05
  4. Brazoria, TX · Texas$28.50−$0.24
  5. Dallas, TX · Texas$28.64−$0.10
  6. Fort Worth, TX · Texas$28.42−$0.32
  7. Galveston, TX · Texas$28.56−$0.18

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

Every other payment area

92504 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$27.55$7.58
Los Angeles, CACalifornia$32.95$8.06
Washington, DC areaDistrict of Columbia$33.07$8.28
Miami, FLFlorida$30.15$8.25
Chicago, ILIllinois$29.31$8.16
Manhattan, NYNew York$32.93$8.48
AlaskaAlaska$33.04$10.63
AlabamaAlabama$25.78$7.37

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 92504 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work0.18× 1.0080.1814
Practice expense0.67× 0.9930.6653
Malpractice0.01× 1.3760.0138
Total RVUs0.8605
Conversion factor× 33.4009

Office rate, Houston, TX$28.74

Office: (0.18 × 1.008 + 0.67 × 0.993 + 0.01 × 1.376) × $33.4009 = $28.74

Facility: (0.18 × 1.008 + 0.04 × 0.993 + 0.01 × 1.376) × $33.4009 = $7.85

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 Houston, TX

92504 · Office / nonfacility

$28.74

Effective 2026-10-01

The base rate is $0.64 higher than on 2025-10-01, moving from $28.10 to $28.74 (2.3%).

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

    $28.10changed to$28.74

    • Conversion factor 32.3465 changed to 33.4009
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $29.25changed to$28.10

    • 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

    $28.77changed to$29.25

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $30.04changed to$28.77

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409
  5. January 1, 2023

    RVU23A

    $30.60changed to$30.04

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.67 changed to 0.68
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $30.85changed to$30.60

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $30.19changed to$30.85

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.63 changed to 0.67
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $30.30changed to$30.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.64 changed to 0.63
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $30.26changed to$30.30

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $30.47changed to$30.26

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.65 changed to 0.64
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $30.68changed to$30.47

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.66 changed to 0.65
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $30.79changed to$30.68

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $30.64changed to$30.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $30.61changed to$30.64

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $31.72changed to$30.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.74 changed to 0.66
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $31.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$28.74$7.85RVU26D
2026-07-01$28.74$7.85RVU26C
2026-04-01$28.74$7.85RVU26B
2026-01-01$28.74$7.85RVU26A
2025-10-01$28.10$9.28RVU25D
2025-07-01$28.10$9.28RVU25C
2025-04-01$28.10$9.28RVU25B
2025-01-01$28.10$9.28RVU25A
2024-10-01$29.25$9.22RVU24D
2024-07-01$29.25$9.22RVU24C
2024-04-01$29.25$9.22RVU24B
2024-03-09$29.25$9.22RVU24AR
2024-01-01$28.77$9.07RVU24A
2023-10-01$30.04$9.73RVU23D
2023-07-01$30.04$9.73RVU23C
2023-04-01$30.04$9.73RVU23B
2023-01-01$30.04$9.73RVU23A
2022-10-01$30.60$9.59RVU22D
2022-07-01$30.60$9.59RVU22C
2022-04-01$30.60$9.59RVU22B
2022-01-01$30.60$9.59RVU22A
2021-10-01$30.85$9.67RVU21D
2021-07-01$30.85$9.67RVU21C
2021-04-01$30.85$9.67RVU21B
2021-01-01$30.85$9.67RVU21A
2020-10-01$30.19$9.94RVU20D
2020-07-01$30.19$9.94RVU20C
2020-04-01$30.19$9.94RVU20B
2020-01-01$30.19$9.94RVU20A
2019-10-01$30.30$9.87RVU19D
2019-07-01$30.30$9.87RVU19C
2019-04-01$30.30$9.87RVU19B
2019-01-01$30.30$9.87RVU19A
2018-10-01$30.26$9.86RVU18D
2018-07-01$30.26$9.86RVU18C
2018-04-01$30.26$9.86RVU18B
2018-01-01$30.26$9.86RVU18AR1
2017-10-01$30.47$9.83RVU17D
2017-07-01$30.47$9.83RVU17C
2017-04-01$30.47$9.83RVU17B
2017-01-01$30.47$9.83RVU17A
2016-10-01$30.68$9.79RVU16D
2016-07-01$30.68$9.79RVU16C
2016-04-01$30.68$9.79RVU16B
2016-01-01$30.68$9.79RVU16A
2015-10-01$30.79$9.83RVU15D
2015-07-01$30.79$9.83RVU15C
2015-04-01$30.64$9.78RVU15B
2015-01-01$30.64$9.78RVU15A
2014-10-01$30.61$9.75RVU14D
2014-07-01$30.61$9.75RVU14C
2014-04-01$30.61$9.75RVU14B
2014-01-01$30.61$9.75RVU14A
2013-10-01$31.72$9.56RVU13D
2013-07-01$31.72$9.56RVU13C
2013-04-01$31.72$9.56RVU13B
2013-01-01$31.72$9.56RVU13AR

Price 92504 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

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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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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