CPT code 92538: Caloric vestibular test, unilateral, with recording2026 Medicare rate & RVUs in Chicago, IL
Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction.
In Chicago, IL, Medicare pays $22.70 for 92538 in the office.
Check a contract rate as a % of Medicare · 92538 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 92538 covers
This test stimulates the vestibular system by introducing warm or cool air or water into the ear canal, then records the resulting eye movements, including nystagmus. Audiologists and physicians such as otolaryngologists may perform or interpret it in an audiology, ENT, or balance-testing setting. It is used as part of a diagnostic evaluation when symptoms or findings suggest impaired vestibular function.
Choose 92538 when recorded caloric testing is performed on one side; 92537 is the bilateral recorded-test sibling. Documentation should identify the ear tested, the stimulation performed, the recorded response, and the interpretation when applicable. The global service includes the professional interpretation and the technical work, equipment, and staff. Modifier 26 reports the interpretation alone, while modifier TC reports the technical portion alone. CMS pricing treats this code as already priced bilaterally, so modifier 50 does not increase payment.
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 Chicago, IL compares for 92538
Across 109 of 109 payment localities, the office rate for 92538 runs from $19.79 in Arkansas to $27.49 in San Benito County, CA. Chicago, IL pays $22.70. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Chicago, IL · this page$22.70
- East St. Louis, IL · Illinois$21.48−$1.22
- Rest of Illinois · Illinois$21.10−$1.60
- Suburban Chicago, IL · Illinois$22.60−$0.10
- Los Angeles, CA · California$23.96+$1.26
- Washington, DC area · District of Columbia$24.33+$1.63
- Miami, FL · Florida$23.20+$0.50
Other areas in Illinois first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NYNew York | $24.56 | — |
| AlaskaAlaska | $26.99 | — |
| AlabamaAlabama | $20.00 | — |
| ArkansasArkansas | $19.79 | — |
| ArizonaArizona | $21.26 | — |
| Bakersfield, CACalifornia | $22.72 | — |
| Chico, CACalifornia | $22.66 | — |
| El Centro, CACalifornia | $22.66 | — |
| Fresno, CACalifornia | $22.66 | — |
| Hanford, CACalifornia | $22.66 | — |
| Madera, CACalifornia | $22.66 | — |
| Merced, CACalifornia | $22.66 | — |
| Modesto, CACalifornia | $22.66 | — |
| Napa, CACalifornia | $25.60 | — |
| Oxnard, CACalifornia | $23.80 | — |
| Redding, CACalifornia | $22.66 | — |
| Rest of CaliforniaCalifornia | $22.66 | — |
| Riverside, CACalifornia | $22.88 | — |
| Sacramento, CACalifornia | $23.60 | — |
| Salinas, CACalifornia | $23.51 | — |
| San Diego, CACalifornia | $23.92 | — |
| Marin County, CACalifornia | $26.93 | — |
| San Francisco, CACalifornia | $26.90 | — |
| San Benito County, CACalifornia | $27.49 | — |
| Santa Clara County, CACalifornia | $27.39 | — |
| San Luis Obispo, CACalifornia | $23.14 | — |
| Santa Cruz, CACalifornia | $24.05 | — |
| Santa Maria, CACalifornia | $23.56 | — |
| Santa Rosa, CACalifornia | $24.28 | — |
| Stockton, CACalifornia | $22.66 | — |
| Vallejo, CACalifornia | $25.57 | — |
| Visalia, CACalifornia | $22.66 | — |
| Yuba City, CACalifornia | $22.66 | — |
| ColoradoColorado | $22.41 | — |
| ConnecticutConnecticut | $22.92 | — |
| DelawareDelaware | $21.56 | — |
| Fort Lauderdale, FLFlorida | $22.40 | — |
| Rest of FloridaFlorida | $21.55 | — |
| Atlanta, GAGeorgia | $22.06 | — |
| Rest of GeorgiaGeorgia | $20.61 | — |
| Hawaii, Guam, HIHawaii | $22.99 | — |
| IowaIowa | $20.34 | — |
| IdahoIdaho | $20.45 | — |
| IndianaIndiana | $20.54 | — |
| KansasKansas | $20.29 | — |
| KentuckyKentucky | $20.39 | — |
| New Orleans, LALouisiana | $21.13 | — |
| Rest of LouisianaLouisiana | $20.38 | — |
| Metropolitan Boston, MAMassachusetts | $24.24 | — |
| Rest of MassachusettsMassachusetts | $22.33 | — |
| Baltimore area, MDMaryland | $22.85 | — |
| Rest of MarylandMaryland | $21.89 | — |
| Rest of MaineMaine | $20.55 | — |
| Southern Maine, MEMaine | $21.36 | — |
| Detroit, MIMichigan | $21.77 | — |
| Rest of MichiganMichigan | $20.81 | — |
| MinnesotaMinnesota | $21.57 | — |
| Metropolitan Kansas City, MOMissouri | $21.00 | — |
| Metropolitan St. Louis, MOMissouri | $21.17 | — |
| Rest of MissouriMissouri | $20.13 | — |
| MississippiMississippi | $19.96 | — |
| MontanaMontana | $21.71 | — |
| North CarolinaNorth Carolina | $20.71 | — |
| North DakotaNorth Dakota | $21.31 | — |
| NebraskaNebraska | $20.42 | — |
| New HampshireNew Hampshire | $22.09 | — |
| Northern New JerseyNew Jersey | $24.18 | — |
| Rest of New JerseyNew Jersey | $23.21 | — |
| New MexicoNew Mexico | $20.90 | — |
| NevadaNevada | $21.61 | — |
| NYC suburbs and Long Island, NYNew York | $25.05 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $23.37 | — |
| Queens, NYNew York | $24.69 | — |
| Rest of New YorkNew York | $20.94 | — |
| OhioOhio | $20.73 | — |
| OklahomaOklahoma | $20.35 | — |
| Portland, OROregon | $22.96 | — |
| Rest of OregonOregon | $21.47 | — |
| Metropolitan Philadelphia, PAPennsylvania | $22.48 | — |
| Rest of PennsylvaniaPennsylvania | $20.74 | — |
| Puerto RicoPuerto Rico | $21.83 | — |
| Rhode IslandRhode Island | $22.20 | — |
| South CarolinaSouth Carolina | $20.75 | — |
| South DakotaSouth Dakota | $21.27 | — |
| TennesseeTennessee | $20.37 | — |
| Austin, TXTexas | $22.31 | — |
| Beaumont, TXTexas | $20.64 | — |
| Brazoria, TXTexas | $21.54 | — |
| Dallas, TXTexas | $21.66 | — |
| Fort Worth, TXTexas | $21.55 | — |
| Galveston, TXTexas | $21.59 | — |
| Houston, TXTexas | $21.96 | — |
| Rest of TexasTexas | $21.07 | — |
| UtahUtah | $20.96 | — |
| VirginiaVirginia | $21.32 | — |
| Virgin Islands, VIUnited States Virgin Islands | $21.83 | — |
| VermontVermont | $21.27 | — |
| Rest of WashingtonWashington | $22.28 | — |
| King County, WAWashington | $24.65 | — |
| WisconsinWisconsin | $20.77 | — |
| West VirginiaWest Virginia | $20.51 | — |
| WyomingWyoming | $21.54 | — |
92538 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.
$19.79
$26.99
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $26.99 | 1 |
| AL | $20.00 | 1 |
| AR | $19.79 | 1 |
| AZ | $21.26 | 1 |
| CA | $22.66–$27.49 | 29 |
| CO | $22.41 | 1 |
| CT | $22.92 | 1 |
| DC | $24.33 | 1 |
| DE | $21.56 | 1 |
| FL | $21.55–$23.20 | 3 |
| GA | $20.61–$22.06 | 2 |
| GU | $22.99 | 1 |
| HI | $22.99 | 1 |
| IA | $20.34 | 1 |
| ID | $20.45 | 1 |
| IL | $21.10–$22.70 | 4 |
| IN | $20.54 | 1 |
| KS | $20.29 | 1 |
| KY | $20.39 | 1 |
| LA | $20.38–$21.13 | 2 |
| MA | $22.33–$24.24 | 2 |
| MD | $21.89–$24.33 | 3 |
| ME | $20.55–$21.36 | 2 |
| MI | $20.81–$21.77 | 2 |
| MN | $21.57 | 1 |
| MO | $20.13–$21.17 | 3 |
| MS | $19.96 | 1 |
| MT | $21.71 | 1 |
| NC | $20.71 | 1 |
| ND | $21.31 | 1 |
| NE | $20.42 | 1 |
| NH | $22.09 | 1 |
| NJ | $23.21–$24.18 | 2 |
| NM | $20.90 | 1 |
| NV | $21.61 | 1 |
| NY | $20.94–$25.05 | 5 |
| OH | $20.73 | 1 |
| OK | $20.35 | 1 |
| OR | $21.47–$22.96 | 2 |
| PA | $20.74–$22.48 | 2 |
| PR | $21.83 | 1 |
| RI | $22.20 | 1 |
| SC | $20.75 | 1 |
| SD | $21.27 | 1 |
| TN | $20.37 | 1 |
| TX | $20.64–$22.31 | 8 |
| UT | $20.96 | 1 |
| VA | $21.32–$24.33 | 2 |
| VI | $21.83 | 1 |
| VT | $21.27 | 1 |
| WA | $22.28–$24.65 | 2 |
| WI | $20.77 | 1 |
| WV | $20.51 | 1 |
| WY | $21.54 | 1 |
How the 92538 rate is calculated
Each of 92538’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 · 92538
RVUs × geographic indexes × conversion factor
Work0.29
0.29 RVUs× 1.000 GPCI
Practice expense0.34
0.34 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.6500
Conversion factor
$33.4009
Medicare rate
$21.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Chicago, IL inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,800
- Code
- 92538
- Physician work
- 0.29
- Practice expense
- 0.34
- Malpractice
- 0.02
GPCI2026.csv
48
- Locality
- Chicago, IL
- Physician work
- 1.007
- Practice expense
- 1.005
- Malpractice
- 2.295
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.29 | × 1.007 | 0.2920 |
| Practice expense | 0.34 | × 1.005 | 0.3417 |
| Malpractice | 0.02 | × 2.295 | 0.0459 |
| Total RVUs | 0.6796 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Chicago, IL$22.70
Office: (0.29 × 1.007 + 0.34 × 1.005 + 0.02 × 2.295) × $33.4009 = $22.70
Payment rules and modifiers for 92538
The CMS indicators that decide how 92538 is paid alongside other services.
CMS payment indicators · 92538
Caloric vestibular test, unilateral, with recording
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
92538 without 26 · national office
$21.71
Caloric vestibular test, unilateral, with recording
92538-26 · Professional component
$15.36
Pays only the interpretation and report.
How 92538 has changed in Chicago, IL
92538 · Office / nonfacility
$22.70
Effective 2026-10-01
The base rate is $0.37 higher than on 2025-10-01, moving from $22.33 to $22.70 (1.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$22.33changed to$22.70
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.30 changed to 0.29
- Practice expense GPCI 1.023 changed to 1.005
- Malpractice GPCI 2.018 changed to 2.295
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$23.32changed to$22.33
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.35 changed to 0.34
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$22.94changed to$23.32
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$23.83changed to$22.94
- Conversion factor 33.8872 changed to 32.7442
- Work GPCI 1.009 changed to 1.007
- Practice expense GPCI 1.033 changed to 1.023
- Malpractice GPCI 1.945 changed to 2.018
January 1, 2023
RVU23A
$24.44changed to$23.83
- Conversion factor 34.6062 changed to 33.8872
- Work GPCI 1.011 changed to 1.009
- Practice expense GPCI 1.044 changed to 1.033
- Malpractice GPCI 1.871 changed to 1.945
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$24.27changed to$24.44
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.34 changed to 0.35
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$24.29changed to$24.27
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.32 changed to 0.34
- Work GPCI 1.009 changed to 1.011
- Practice expense GPCI 1.039 changed to 1.044
- Malpractice GPCI 1.898 changed to 1.871
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$22.72changed to$24.29
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.28 changed to 0.32
- Work GPCI 1.008 changed to 1.009
- Practice expense GPCI 1.034 changed to 1.039
- Malpractice GPCI 1.925 changed to 1.898
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$22.32changed to$22.72
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.27 changed to 0.28
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$21.98changed to$22.32
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.26 changed to 0.27
- Work GPCI 1.012 changed to 1.008
- Practice expense GPCI 1.036 changed to 1.034
- Malpractice GPCI 1.972 changed to 1.925
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$22.01changed to$21.98
- Conversion factor 35.8043 changed to 35.8887
- Work GPCI 1.016 changed to 1.012
- Practice expense GPCI 1.037 changed to 1.036
- Malpractice GPCI 2.019 changed to 1.972
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
No ratechanged to$22.01
Held through RVU16B, RVU16C, RVU16D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $22.70 | Not available in this setting | RVU26D |
| 2026-07-01 | $22.70 | Not available in this setting | RVU26C |
| 2026-04-01 | $22.70 | Not available in this setting | RVU26B |
| 2026-01-01 | $22.70 | Not available in this setting | RVU26A |
| 2025-10-01 | $22.33 | Not available in this setting | RVU25D |
| 2025-07-01 | $22.33 | Not available in this setting | RVU25C |
| 2025-04-01 | $22.33 | Not available in this setting | RVU25B |
| 2025-01-01 | $22.33 | Not available in this setting | RVU25A |
| 2024-10-01 | $23.32 | Not available in this setting | RVU24D |
| 2024-07-01 | $23.32 | Not available in this setting | RVU24C |
| 2024-04-01 | $23.32 | Not available in this setting | RVU24B |
| 2024-03-09 | $23.32 | Not available in this setting | RVU24AR |
| 2024-01-01 | $22.94 | Not available in this setting | RVU24A |
| 2023-10-01 | $23.83 | Not available in this setting | RVU23D |
| 2023-07-01 | $23.83 | Not available in this setting | RVU23C |
| 2023-04-01 | $23.83 | Not available in this setting | RVU23B |
| 2023-01-01 | $23.83 | Not available in this setting | RVU23A |
| 2022-10-01 | $24.44 | Not available in this setting | RVU22D |
| 2022-07-01 | $24.44 | Not available in this setting | RVU22C |
| 2022-04-01 | $24.44 | Not available in this setting | RVU22B |
| 2022-01-01 | $24.44 | Not available in this setting | RVU22A |
| 2021-10-01 | $24.27 | Not available in this setting | RVU21D |
| 2021-07-01 | $24.27 | Not available in this setting | RVU21C |
| 2021-04-01 | $24.27 | Not available in this setting | RVU21B |
| 2021-01-01 | $24.27 | Not available in this setting | RVU21A |
| 2020-10-01 | $24.29 | Not available in this setting | RVU20D |
| 2020-07-01 | $24.29 | Not available in this setting | RVU20C |
| 2020-04-01 | $24.29 | Not available in this setting | RVU20B |
| 2020-01-01 | $24.29 | Not available in this setting | RVU20A |
| 2019-10-01 | $22.72 | Not available in this setting | RVU19D |
| 2019-07-01 | $22.72 | Not available in this setting | RVU19C |
| 2019-04-01 | $22.72 | Not available in this setting | RVU19B |
| 2019-01-01 | $22.72 | Not available in this setting | RVU19A |
| 2018-10-01 | $22.32 | Not available in this setting | RVU18D |
| 2018-07-01 | $22.32 | Not available in this setting | RVU18C |
| 2018-04-01 | $22.32 | Not available in this setting | RVU18B |
| 2018-01-01 | $22.32 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $21.98 | Not available in this setting | RVU17D |
| 2017-07-01 | $21.98 | Not available in this setting | RVU17C |
| 2017-04-01 | $21.98 | Not available in this setting | RVU17B |
| 2017-01-01 | $21.98 | Not available in this setting | RVU17A |
| 2016-10-01 | $22.01 | Not available in this setting | RVU16D |
| 2016-07-01 | $22.01 | Not available in this setting | RVU16C |
| 2016-04-01 | $22.01 | Not available in this setting | RVU16B |
| 2016-01-01 | $22.01 | Not available in this setting | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Chicago, IL rate applies
Chicago, IL is a Medicare payment area, not a city. Our Census mapping connects it to 137 cities and communities in Illinois. Some span more than one payment area; confirm with the service ZIP.
- 92538 in Chicago · multiple payment areas
- Alsip
- Arlington Heights
- 92538 in Barrington · multiple payment areas
- 92538 in Barrington Hills · multiple payment areas
- 92538 in Bartlett · multiple payment areas
- Bedford Park
- Bellwood
92538 billing questions
How does 92538 differ from 92537?
92538 is for recorded caloric testing on one side; 92537 is the bilateral recorded-test code. Document which ear was tested.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical portion. Without either modifier, the code represents the global service.
Should modifier 50 be added when both ears are tested?
No. CMS pricing treats 92538 as already priced bilaterally, and modifier 50 does not increase payment. Use the code that reflects the service performed and document the tested ear or ears.
What documentation supports 92538?
Record the ear tested, the caloric stimulation performed, the eye-movement response, and the interpretation. The record should support that the test included recording.
When is 92533 a better fit?
92533 describes caloric vestibular testing without recording. Use 92538 when the caloric test includes recording.
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
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