CPT code 92542: Positional nystagmus, with recording2026 Medicare rate & RVUs

Medicare pays $28.39 for 92542 nationally in the office. Local office rates run $26.37–$36.72.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 92542 covers

For this test, the clinician changes the patient’s head or body position and observes and records resulting nystagmus, or involuntary rhythmic eye movement. It is commonly performed by an audiologist or an ear, nose, and throat specialist as part of an evaluation for dizziness, vertigo, or suspected positional vestibular dysfunction. The recorded findings help characterize whether eye movements are triggered by position and support the broader clinical assessment; this test alone does not establish a diagnosis such as benign paroxysmal positional vertigo.

Report 92542 when positional testing is performed with recording. The record should identify the maneuvers or positions tested, document the observed eye movements and relevant findings, and support the interpretation. The related unrecorded test is 92532. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or neither modifier for the global service. When the positional test is included in the broader basic vestibular evaluation reported with 92540, do not separately report it as an additional service.

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 92542 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

92542 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 92542 rate is calculated

Each of 92542’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.

Payment rules and modifiers for 92542

The CMS indicators that decide how 92542 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

92542 compared with similar codes

How to choose

92532Positional nystagmusWithout recording

Use 92542 for positional nystagmus testing with recording; use 92532 when the test is performed without recording.

92541Nystagmus testSpontaneous, with recording

92541 evaluates spontaneous nystagmus, rather than eye movements elicited by changing the patient’s position.

92540Vestibular evaluationBasic test battery

92540 represents a broader basic vestibular evaluation that includes positional nystagmus testing. Do not separately report 92542 for that included service.

Codes related to 92542

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates