CPT code 92538: Caloric vestibular test, unilateral, with recording2026 Medicare rate & RVUs in New Hampshire

Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction.

CMS RVU26DEffective Oct 1, 2026One payment locality5.5K Medicare services in 2024

In New Hampshire, Medicare pays $22.09 for 92538 in the office.

$22.09Office (non-facility)
Not available in this settingHospital or facility
+1.8%vs the national office rate ($21.71)

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.

We’ll open 92538 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Hampshire
  2. What 92538 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 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 New Hampshire 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. New Hampshire pays $22.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

92538 in New Hampshire vs other payment areas
  1. New Hampshire · this page$22.09
  2. Los Angeles, CA · California$23.96+$1.87
  3. Washington, DC area · District of Columbia$24.33+$2.24
  4. Miami, FL · Florida$23.20+$1.11
  5. Chicago, IL · Illinois$22.70+$0.61
  6. Manhattan, NY · New York$24.56+$2.47
  7. Alaska · Alaska$26.99+$4.90

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

Every other payment area

92538 in every other Medicare payment locality
Payment localityOfficeFacility
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—

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
92538 office rate range by state
State / territoryOffice rate rangeLocalities
AK$26.991
AL$20.001
AR$19.791
AZ$21.261
CA$22.66–$27.4929
CO$22.411
CT$22.921
DC$24.331
DE$21.561
FL$21.55–$23.203
GA$20.61–$22.062
GU$22.991
HI$22.991
IA$20.341
ID$20.451
IL$21.10–$22.704
IN$20.541
KS$20.291
KY$20.391
LA$20.38–$21.132
MA$22.33–$24.242
MD$21.89–$24.333
ME$20.55–$21.362
MI$20.81–$21.772
MN$21.571
MO$20.13–$21.173
MS$19.961
MT$21.711
NC$20.711
ND$21.311
NE$20.421
NH$22.091
NJ$23.21–$24.182
NM$20.901
NV$21.611
NY$20.94–$25.055
OH$20.731
OK$20.351
OR$21.47–$22.962
PA$20.74–$22.482
PR$21.831
RI$22.201
SC$20.751
SD$21.271
TN$20.371
TX$20.64–$22.318
UT$20.961
VA$21.32–$24.332
VI$21.831
VT$21.271
WA$22.28–$24.652
WI$20.771
WV$20.511
WY$21.541

See 92538 in every payment locality

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

Office or facility?

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 New Hampshire 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

74

Locality
New Hampshire
Physician work
1.000
Practice expense
1.041
Malpractice
0.875
Office calculation for 92538 in New Hampshire
ComponentRVULocality factorAdjusted
Physician work0.29× 1.0000.2900
Practice expense0.34× 1.0410.3539
Malpractice0.02× 0.8750.0175
Total RVUs0.6614
Conversion factor× 33.4009

Office rate, New Hampshire$22.09

Office: (0.29 × 1 + 0.34 × 1.041 + 0.02 × 0.875) × $33.4009 = $22.09

Open 92538 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

How 92538 has changed in New Hampshire

92538 · Office / nonfacility

$22.09

Effective 2026-10-01

The base rate is $0.43 higher than on 2025-10-01, moving from $21.66 to $22.09 (2.0%).

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

    $21.66changed to$22.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.30 changed to 0.29
    • Practice expense GPCI 1.034 changed to 1.041
    • Malpractice GPCI 0.898 changed to 0.875

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $22.63changed to$21.66

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.35 changed to 0.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $22.26changed to$22.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $23.07changed to$22.26

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 1.036 changed to 1.034
    • Malpractice GPCI 0.907 changed to 0.898
  5. January 1, 2023

    RVU23A

    $23.59changed to$23.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense GPCI 1.038 changed to 1.036
    • Malpractice GPCI 0.917 changed to 0.907

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $23.42changed to$23.59

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.34 changed to 0.35

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $23.57changed to$23.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.32 changed to 0.34
    • Practice expense GPCI 1.042 changed to 1.038
    • Malpractice GPCI 0.984 changed to 0.917

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $22.11changed to$23.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.28 changed to 0.32
    • Practice expense GPCI 1.045 changed to 1.042
    • Malpractice GPCI 1.050 changed to 0.984

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $21.71changed to$22.11

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.27 changed to 0.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $21.27changed to$21.71

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.26 changed to 0.27
    • Practice expense GPCI 1.052 changed to 1.045
    • Malpractice GPCI 0.962 changed to 1.050

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $21.22changed to$21.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.058 changed to 1.052
    • Malpractice GPCI 0.873 changed to 0.962

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    No ratechanged to$21.22

    Held through RVU16B, RVU16C, RVU16D.

  13. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$22.09Not available in this settingRVU26D
2026-07-01$22.09Not available in this settingRVU26C
2026-04-01$22.09Not available in this settingRVU26B
2026-01-01$22.09Not available in this settingRVU26A
2025-10-01$21.66Not available in this settingRVU25D
2025-07-01$21.66Not available in this settingRVU25C
2025-04-01$21.66Not available in this settingRVU25B
2025-01-01$21.66Not available in this settingRVU25A
2024-10-01$22.63Not available in this settingRVU24D
2024-07-01$22.63Not available in this settingRVU24C
2024-04-01$22.63Not available in this settingRVU24B
2024-03-09$22.63Not available in this settingRVU24AR
2024-01-01$22.26Not available in this settingRVU24A
2023-10-01$23.07Not available in this settingRVU23D
2023-07-01$23.07Not available in this settingRVU23C
2023-04-01$23.07Not available in this settingRVU23B
2023-01-01$23.07Not available in this settingRVU23A
2022-10-01$23.59Not available in this settingRVU22D
2022-07-01$23.59Not available in this settingRVU22C
2022-04-01$23.59Not available in this settingRVU22B
2022-01-01$23.59Not available in this settingRVU22A
2021-10-01$23.42Not available in this settingRVU21D
2021-07-01$23.42Not available in this settingRVU21C
2021-04-01$23.42Not available in this settingRVU21B
2021-01-01$23.42Not available in this settingRVU21A
2020-10-01$23.57Not available in this settingRVU20D
2020-07-01$23.57Not available in this settingRVU20C
2020-04-01$23.57Not available in this settingRVU20B
2020-01-01$23.57Not available in this settingRVU20A
2019-10-01$22.11Not available in this settingRVU19D
2019-07-01$22.11Not available in this settingRVU19C
2019-04-01$22.11Not available in this settingRVU19B
2019-01-01$22.11Not available in this settingRVU19A
2018-10-01$21.71Not available in this settingRVU18D
2018-07-01$21.71Not available in this settingRVU18C
2018-04-01$21.71Not available in this settingRVU18B
2018-01-01$21.71Not available in this settingRVU18AR1
2017-10-01$21.27Not available in this settingRVU17D
2017-07-01$21.27Not available in this settingRVU17C
2017-04-01$21.27Not available in this settingRVU17B
2017-01-01$21.27Not available in this settingRVU17A
2016-10-01$21.22Not available in this settingRVU16D
2016-07-01$21.22Not available in this settingRVU16C
2016-04-01$21.22Not available in this settingRVU16B
2016-01-01$21.22Not available in this settingRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 92538 for an earlier date of service

Where the New Hampshire rate applies

New Hampshire is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in New Hampshire. Some span more than one payment area; confirm with the service ZIP.

  • Alton
  • Amherst
  • Antrim
  • Ashland
  • Bartlett
  • Belmont
  • Bennington
  • Berlin

Browse all communities in New Hampshire

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
RVUs for 92538PPRRVU2026_Oct_nonQPP.csv, line 11,800 (RVU26D)
Geographic factors for New HampshireGPCI2026.csv, line 74 (RVU26D)

Open CMS sourceHow we calculate rates

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