CPT code 92541: Nystagmus test, spontaneous, with recording2026 Medicare rate & RVUs in Iowa
Reports recorded assessment of spontaneous and gaze-related nystagmus during vestibular testing, often used to evaluate patients with dizziness or balance symptoms.
In Iowa, Medicare pays $23.38 for 92541 in the office.
Check a contract rate as a % of Medicare · 92541 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 92541 covers
This vestibular test records involuntary eye movements that occur spontaneously and during gaze assessment. Audiologists, otolaryngologists, and other clinicians performing vestibular evaluations may use electronystagmography or videonystagmography equipment in an audiology clinic, ENT practice, or vestibular laboratory. Results can help characterize eye-movement findings in patients evaluated for dizziness, vertigo, or imbalance.
Report 92541 for the recorded spontaneous nystagmus assessment, including gaze; documentation should identify the test performed and its recorded findings. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for interpretation, modifier TC for the technical service, or neither modifier for the global service. The recorded assessment differs from a basic vestibular evaluation code that represents a defined combination of tests.
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 Iowa compares for 92541
Across 109 of 109 payment localities, the office rate for 92541 runs from $22.84 in Arkansas to $31.65 in Alaska. Iowa pays $23.38. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$23.38
- Los Angeles, CA · California$27.04+$3.66
- Washington, DC area · District of Columbia$27.46+$4.08
- Miami, FL · Florida$26.19+$2.81
- Chicago, IL · Illinois$25.73+$2.35
- Manhattan, NY · New York$27.73+$4.35
- Alaska · Alaska$31.65+$8.27
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $23.05 | — |
| ArkansasArkansas | $22.84 | — |
| ArizonaArizona | $24.28 | — |
| Bakersfield, CACalifornia | $25.76 | — |
| Chico, CACalifornia | $25.69 | — |
| El Centro, CACalifornia | $25.69 | — |
| Fresno, CACalifornia | $25.69 | — |
| Hanford, CACalifornia | $25.69 | — |
| Madera, CACalifornia | $25.69 | — |
| Merced, CACalifornia | $25.69 | — |
| Modesto, CACalifornia | $25.69 | — |
| Napa, CACalifornia | $28.71 | — |
| Oxnard, CACalifornia | $26.84 | — |
| Redding, CACalifornia | $25.69 | — |
| Rest of CaliforniaCalifornia | $25.69 | — |
| Riverside, CACalifornia | $25.91 | — |
| Sacramento, CACalifornia | $26.67 | — |
| Salinas, CACalifornia | $26.56 | — |
| San Diego, CACalifornia | $26.96 | — |
| Marin County, CACalifornia | $30.11 | — |
| San Francisco, CACalifornia | $30.09 | — |
| San Benito County, CACalifornia | $30.71 | — |
| Santa Clara County, CACalifornia | $30.62 | — |
| San Luis Obispo, CACalifornia | $26.16 | — |
| Santa Cruz, CACalifornia | $27.05 | — |
| Santa Maria, CACalifornia | $26.60 | — |
| Santa Rosa, CACalifornia | $27.31 | — |
| Stockton, CACalifornia | $25.69 | — |
| Vallejo, CACalifornia | $28.68 | — |
| Visalia, CACalifornia | $25.69 | — |
| Yuba City, CACalifornia | $25.69 | — |
| ColoradoColorado | $25.43 | — |
| ConnecticutConnecticut | $25.97 | — |
| DelawareDelaware | $24.58 | — |
| Fort Lauderdale, FLFlorida | $25.40 | — |
| Rest of FloridaFlorida | $24.57 | — |
| Atlanta, GAGeorgia | $25.07 | — |
| Rest of GeorgiaGeorgia | $23.65 | — |
| Hawaii, Guam, HIHawaii | $25.95 | — |
| IdahoIdaho | $23.48 | — |
| East St. Louis, ILIllinois | $24.51 | — |
| Rest of IllinoisIllinois | $24.13 | — |
| Suburban Chicago, ILIllinois | $25.62 | — |
| IndianaIndiana | $23.57 | — |
| KansasKansas | $23.33 | — |
| KentuckyKentucky | $23.44 | — |
| New Orleans, LALouisiana | $24.16 | — |
| Rest of LouisianaLouisiana | $23.42 | — |
| Metropolitan Boston, MAMassachusetts | $27.32 | — |
| Rest of MassachusettsMassachusetts | $25.37 | — |
| Baltimore area, MDMaryland | $25.89 | — |
| Rest of MarylandMaryland | $24.92 | — |
| Rest of MaineMaine | $23.58 | — |
| Southern Maine, MEMaine | $24.37 | — |
| Detroit, MIMichigan | $24.79 | — |
| Rest of MichiganMichigan | $23.84 | — |
| MinnesotaMinnesota | $24.57 | — |
| Metropolitan Kansas City, MOMissouri | $24.03 | — |
| Metropolitan St. Louis, MOMissouri | $24.19 | — |
| Rest of MissouriMissouri | $23.18 | — |
| MississippiMississippi | $23.01 | — |
| MontanaMontana | $24.72 | — |
| North CarolinaNorth Carolina | $23.74 | — |
| North DakotaNorth Dakota | $24.32 | — |
| NebraskaNebraska | $23.45 | — |
| New HampshireNew Hampshire | $25.09 | — |
| Northern New JerseyNew Jersey | $27.35 | — |
| Rest of New JerseyNew Jersey | $26.32 | — |
| New MexicoNew Mexico | $23.94 | — |
| NevadaNevada | $24.62 | — |
| NYC suburbs and Long Island, NYNew York | $28.21 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $26.49 | — |
| Queens, NYNew York | $27.85 | — |
| Rest of New YorkNew York | $23.97 | — |
| OhioOhio | $23.76 | — |
| OklahomaOklahoma | $23.39 | — |
| Portland, OROregon | $25.98 | — |
| Rest of OregonOregon | $24.47 | — |
| Metropolitan Philadelphia, PAPennsylvania | $25.53 | — |
| Rest of PennsylvaniaPennsylvania | $23.78 | — |
| Puerto RicoPuerto Rico | $24.83 | — |
| Rhode IslandRhode Island | $25.26 | — |
| South CarolinaSouth Carolina | $23.78 | — |
| South DakotaSouth Dakota | $24.27 | — |
| TennesseeTennessee | $23.40 | — |
| Austin, TXTexas | $25.31 | — |
| Beaumont, TXTexas | $23.68 | — |
| Brazoria, TXTexas | $24.57 | — |
| Dallas, TXTexas | $24.69 | — |
| Fort Worth, TXTexas | $24.59 | — |
| Galveston, TXTexas | $24.63 | — |
| Houston, TXTexas | $24.99 | — |
| Rest of TexasTexas | $24.09 | — |
| UtahUtah | $23.99 | — |
| VirginiaVirginia | $24.33 | — |
| Virgin Islands, VIUnited States Virgin Islands | $24.83 | — |
| VermontVermont | $24.28 | — |
| Rest of WashingtonWashington | $25.31 | — |
| King County, WAWashington | $27.75 | — |
| WisconsinWisconsin | $23.79 | — |
| West VirginiaWest Virginia | $23.56 | — |
| WyomingWyoming | $24.54 | — |
92541 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.
$22.84
$31.65
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 | $31.65 | 1 |
| AL | $23.05 | 1 |
| AR | $22.84 | 1 |
| AZ | $24.28 | 1 |
| CA | $25.69–$30.71 | 29 |
| CO | $25.43 | 1 |
| CT | $25.97 | 1 |
| DC | $27.46 | 1 |
| DE | $24.58 | 1 |
| FL | $24.57–$26.19 | 3 |
| GA | $23.65–$25.07 | 2 |
| GU | $25.95 | 1 |
| HI | $25.95 | 1 |
| IA | $23.38 | 1 |
| ID | $23.48 | 1 |
| IL | $24.13–$25.73 | 4 |
| IN | $23.57 | 1 |
| KS | $23.33 | 1 |
| KY | $23.44 | 1 |
| LA | $23.42–$24.16 | 2 |
| MA | $25.37–$27.32 | 2 |
| MD | $24.92–$27.46 | 3 |
| ME | $23.58–$24.37 | 2 |
| MI | $23.84–$24.79 | 2 |
| MN | $24.57 | 1 |
| MO | $23.18–$24.19 | 3 |
| MS | $23.01 | 1 |
| MT | $24.72 | 1 |
| NC | $23.74 | 1 |
| ND | $24.32 | 1 |
| NE | $23.45 | 1 |
| NH | $25.09 | 1 |
| NJ | $26.32–$27.35 | 2 |
| NM | $23.94 | 1 |
| NV | $24.62 | 1 |
| NY | $23.97–$28.21 | 5 |
| OH | $23.76 | 1 |
| OK | $23.39 | 1 |
| OR | $24.47–$25.98 | 2 |
| PA | $23.78–$25.53 | 2 |
| PR | $24.83 | 1 |
| RI | $25.26 | 1 |
| SC | $23.78 | 1 |
| SD | $24.27 | 1 |
| TN | $23.40 | 1 |
| TX | $23.68–$25.31 | 8 |
| UT | $23.99 | 1 |
| VA | $24.33–$27.46 | 2 |
| VI | $24.83 | 1 |
| VT | $24.28 | 1 |
| WA | $25.31–$27.75 | 2 |
| WI | $23.79 | 1 |
| WV | $23.56 | 1 |
| WY | $24.54 | 1 |
How the 92541 rate is calculated
Each of 92541’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 · 92541
RVUs × geographic indexes × conversion factor
Work0.39
0.39 RVUs× 1.000 GPCI
Practice expense0.33
0.33 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.7400
Conversion factor
$33.4009
Medicare rate
$24.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,806
- Code
- 92541
- Physician work
- 0.39
- Practice expense
- 0.33
- Malpractice
- 0.02
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.39 | × 1.000 | 0.3900 |
| Practice expense | 0.33 | × 0.915 | 0.3020 |
| Malpractice | 0.02 | × 0.397 | 0.0079 |
| Total RVUs | 0.6999 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$23.38
Office: (0.39 × 1 + 0.33 × 0.915 + 0.02 × 0.397) × $33.4009 = $23.38
Payment rules and modifiers for 92541
The CMS indicators that decide how 92541 is paid alongside other services.
CMS payment indicators · 92541
Nystagmus test, spontaneous, 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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
92541 without 26 · national office
$24.72
Nystagmus test, spontaneous, with recording
92541-26 · Professional component
$20.37
Pays only the interpretation and report.
How 92541 has changed in Iowa
92541 · Office / nonfacility
$23.38
Effective 2026-10-01
The base rate is $0.40 higher than on 2025-10-01, moving from $22.98 to $23.38 (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
$22.98changed to$23.38
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.40 changed to 0.39
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$23.65changed to$22.98
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$23.26changed to$23.65
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$24.03changed to$23.26
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$24.49changed to$24.03
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$24.38changed to$24.49
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.32 changed to 0.33
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$24.56changed to$24.38
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.30 changed to 0.32
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$24.20changed to$24.56
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.29 changed to 0.30
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$23.85changed to$24.20
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.28 changed to 0.29
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$23.75changed to$23.85
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$23.02changed to$23.75
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.26 changed to 0.28
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$21.49changed to$23.02
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.21 changed to 0.26
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$21.38changed to$21.49
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$28.73changed to$21.38
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.44 changed to 0.21
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$28.10changed to$28.73
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.47 changed to 0.44
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $28.10
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $23.38 | Not available in this setting | RVU26D |
| 2026-07-01 | $23.38 | Not available in this setting | RVU26C |
| 2026-04-01 | $23.38 | Not available in this setting | RVU26B |
| 2026-01-01 | $23.38 | Not available in this setting | RVU26A |
| 2025-10-01 | $22.98 | Not available in this setting | RVU25D |
| 2025-07-01 | $22.98 | Not available in this setting | RVU25C |
| 2025-04-01 | $22.98 | Not available in this setting | RVU25B |
| 2025-01-01 | $22.98 | Not available in this setting | RVU25A |
| 2024-10-01 | $23.65 | Not available in this setting | RVU24D |
| 2024-07-01 | $23.65 | Not available in this setting | RVU24C |
| 2024-04-01 | $23.65 | Not available in this setting | RVU24B |
| 2024-03-09 | $23.65 | Not available in this setting | RVU24AR |
| 2024-01-01 | $23.26 | Not available in this setting | RVU24A |
| 2023-10-01 | $24.03 | Not available in this setting | RVU23D |
| 2023-07-01 | $24.03 | Not available in this setting | RVU23C |
| 2023-04-01 | $24.03 | Not available in this setting | RVU23B |
| 2023-01-01 | $24.03 | Not available in this setting | RVU23A |
| 2022-10-01 | $24.49 | Not available in this setting | RVU22D |
| 2022-07-01 | $24.49 | Not available in this setting | RVU22C |
| 2022-04-01 | $24.49 | Not available in this setting | RVU22B |
| 2022-01-01 | $24.49 | Not available in this setting | RVU22A |
| 2021-10-01 | $24.38 | Not available in this setting | RVU21D |
| 2021-07-01 | $24.38 | Not available in this setting | RVU21C |
| 2021-04-01 | $24.38 | Not available in this setting | RVU21B |
| 2021-01-01 | $24.38 | Not available in this setting | RVU21A |
| 2020-10-01 | $24.56 | Not available in this setting | RVU20D |
| 2020-07-01 | $24.56 | Not available in this setting | RVU20C |
| 2020-04-01 | $24.56 | Not available in this setting | RVU20B |
| 2020-01-01 | $24.56 | Not available in this setting | RVU20A |
| 2019-10-01 | $24.20 | Not available in this setting | RVU19D |
| 2019-07-01 | $24.20 | Not available in this setting | RVU19C |
| 2019-04-01 | $24.20 | Not available in this setting | RVU19B |
| 2019-01-01 | $24.20 | Not available in this setting | RVU19A |
| 2018-10-01 | $23.85 | Not available in this setting | RVU18D |
| 2018-07-01 | $23.85 | Not available in this setting | RVU18C |
| 2018-04-01 | $23.85 | Not available in this setting | RVU18B |
| 2018-01-01 | $23.85 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $23.75 | Not available in this setting | RVU17D |
| 2017-07-01 | $23.75 | Not available in this setting | RVU17C |
| 2017-04-01 | $23.75 | Not available in this setting | RVU17B |
| 2017-01-01 | $23.75 | Not available in this setting | RVU17A |
| 2016-10-01 | $23.02 | Not available in this setting | RVU16D |
| 2016-07-01 | $23.02 | Not available in this setting | RVU16C |
| 2016-04-01 | $23.02 | Not available in this setting | RVU16B |
| 2016-01-01 | $23.02 | Not available in this setting | RVU16A |
| 2015-10-01 | $21.49 | Not available in this setting | RVU15D |
| 2015-07-01 | $21.49 | Not available in this setting | RVU15C |
| 2015-04-01 | $21.38 | Not available in this setting | RVU15B |
| 2015-01-01 | $21.38 | Not available in this setting | RVU15A |
| 2014-10-01 | $28.73 | Not available in this setting | RVU14D |
| 2014-07-01 | $28.73 | Not available in this setting | RVU14C |
| 2014-04-01 | $28.73 | Not available in this setting | RVU14B |
| 2014-01-01 | $28.73 | Not available in this setting | RVU14A |
| 2013-10-01 | $28.10 | Not available in this setting | RVU13D |
| 2013-07-01 | $28.10 | Not available in this setting | RVU13C |
| 2013-04-01 | $28.10 | Not available in this setting | RVU13B |
| 2013-01-01 | $28.10 | Not available in this setting | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
92541 billing questions
How does 92541 differ from 92531?
92541 describes the spontaneous and gaze assessment with recording. The 92531 code is the nearby option for the corresponding study without recording.
When should 92540 be considered instead?
92540 represents a basic vestibular evaluation that includes spontaneous nystagmus, positional nystagmus, optokinetic nystagmus, and oscillating tracking tests. Use 92541 for the individual recorded spontaneous nystagmus assessment.
Which modifier identifies interpretation?
Append modifier 26 when billing only the professional interpretation. Modifier TC identifies the technical service, and billing without either modifier represents the global service.
What should the record support?
Document that spontaneous and gaze-related eye movements were assessed and recorded, along with the findings and the interpretation when the professional component is billed.
Is this the positional nystagmus test?
No. 92541 addresses spontaneous nystagmus, including gaze assessment; 92542 is the recorded positional nystagmus test.
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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