CPT code 92538: Caloric vestibular test, unilateral, with recording2026 Medicare rate & RVUs in Texas
Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction.
Medicare pays $20.64–$22.31 for 92538 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 92538 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$20.64 to $22.31
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $22.31 | Unavailable |
| Beaumont, TX | $20.64 | Unavailable |
| Brazoria, TX | $21.54 | Unavailable |
| Dallas, TX | $21.66 | Unavailable |
| Fort Worth, TX | $21.55 | Unavailable |
| Galveston, TX | $21.59 | Unavailable |
| Houston, TX | $21.96 | Unavailable |
| Rest of Texas | $21.07 | Unavailable |
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.
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.
92538 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 92537Caloric testWith eye-movement recording
- 92538 is for recorded caloric testing on one side; 92537 is the bilateral recorded-test code.
- 92533Caloric vestibular testEach irrigation
- 92533 is caloric vestibular testing without recording. Choose 92538 when the test includes recording.
- 92540Vestibular evaluationBasic test battery
- 92540 is a basic vestibular evaluation, not the specific recorded caloric stimulus and response reported with 92538.
- 92532Positional nystagmusWithout recording
- 92532 evaluates positional nystagmus; 92538 records the vestibular response to caloric stimulation.
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
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