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CPT code 92546: Rotational test, sinusoidal chair rotation2026 Medicare rate & RVUs in Washington, DC area

Sinusoidal rotational testing records eye movements during controlled chair rotation to assess vestibulo-ocular reflex function in patients with dizziness or imbalance.

CMS RVU26DEffective Oct 1, 2026One payment locality43.1K Medicare services in 2024

In Washington, DC area, Medicare pays $157.34 for 92546 in the office.

$157.34Office (non-facility)
Not available in this settingHospital or facility
+16.9%vs the national office rate ($134.61)

Check a contract rate as a % of Medicare · 92546 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 92546 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 92546 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 92546 covers

This vestibular test uses a rotating chair to deliver smooth, back-and-forth changes in rotational speed while eye movements are recorded. The response helps assess vestibulo-ocular reflex function, including in patients evaluated for persistent dizziness, imbalance, or suspected vestibular hypofunction. Audiologists and otolaryngology or neurotology teams commonly perform it in a vestibular laboratory or audiology setting.

Report 92546 for the sinusoidal rotational test itself, supported by documentation of the clinical indication, test performed, recorded response, and interpretation. It is distinct from eye-movement tests that use visual tracking or positional changes, and from caloric testing that stimulates the vestibular system through ear irrigation. For Medicare, modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff service, and no modifier represents the global 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.

How Washington, DC area compares for 92546

Across 109 of 109 payment localities, the office rate for 92546 runs from $116.60 in Arkansas to $190.09 in San Benito County, CA. Washington, DC area pays $157.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

92546 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$157.34
  2. Los Angeles, CA · California$157.39+$0.05
  3. Miami, FL · Florida$141.23−$16.11
  4. Chicago, IL · Illinois$136.59−$20.75
  5. Manhattan, NY · New York$155.92−$1.42
  6. Alaska · Alaska$146.91−$10.43
  7. Alabama · Alabama$118.64−$38.70

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

92546 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$116.60—
ArizonaArizona$130.61—
Bakersfield, CACalifornia$146.32—
Chico, CACalifornia$146.23—
El Centro, CACalifornia$146.23—
Fresno, CACalifornia$146.23—
Hanford, CACalifornia$146.23—
Madera, CACalifornia$146.23—

92546 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$116.60

$168.16

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92546 office rate range by state
State / territoryOffice rate rangeLocalities
AK$146.911
AL$118.641
AR$116.601
AZ$130.611
CA$146.23–$190.0929
CO$142.451
CT$144.571
DC$157.341
DE$133.061
FL$129.64–$141.233
GA$121.38–$136.822
GU$151.211
HI$151.211
IA$123.441
ID$124.141
IL$124.36–$138.804
IN$125.021
KS$122.181
KY$120.731
LA$120.27–$127.412
MA$141.14–$158.982
MD$136.11–$157.343
ME$124.29–$133.122
MI$123.93–$130.942
MN$137.501
MO$117.43–$128.643
MS$117.071
MT$134.601
NC$125.921
ND$134.011
NE$124.421
NH$139.571
NJ$146.51–$155.142
NM$124.491
NV$134.561
NY$128.10–$159.555
OH$123.801
OK$121.091
OR$133.81–$148.292
PA$124.36–$140.062
PR$135.961
RI$138.781
SC$125.011
SD$133.941
TN$122.831
TX$123.35–$141.728
UT$127.051
VA$132.20–$157.342
VI$135.961
VT$132.871
WA$141.07–$163.092
WI$128.691
WV$118.761
WY$134.351

See 92546 in every payment locality

How the 92546 rate is calculated

Each of 92546’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 · 92546

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.28

0.28 RVUs× 1.000 GPCI

Practice expense3.72

3.72 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

4.0300

Conversion factor

$33.4009

Medicare rate

$134.61

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,818

Code
92546
Physician work
0.28
Practice expense
3.72
Malpractice
0.03

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 92546 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.28× 1.0540.2951
Practice expense3.72× 1.1784.3822
Malpractice0.03× 1.1130.0334
Total RVUs4.7107
Conversion factor× 33.4009

Office rate, Washington, DC area$157.34

Office: (0.28 × 1.054 + 3.72 × 1.178 + 0.03 × 1.113) × $33.4009 = $157.34

Open 92546 in the RVU calculator

Payment rules and modifiers for 92546

The CMS indicators that decide how 92546 is paid alongside other services.

CMS payment indicators · 92546

Rotational test, sinusoidal chair rotation

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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

92546 without 26 · national office

$134.61

Rotational test, sinusoidal chair rotation

92546-26 · Professional component

$14.70

Pays only the interpretation and report.

When to use modifier 26

Codes related to 92546

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

Codes related to 92546
CodeHow it relatesOffice range, Washington, DC area
Often billed with
92540Vestibular evaluation, basic test batteryA basic vestibular evaluation may accompany separately performed sinusoidal chair testing.$115.88
92533Caloric vestibular test, each irrigationCaloric testing may be performed during the same vestibular workup using a different stimulus.No office rate
92545Vestibular test, oscillating target trackingVisual tracking testing may be performed with rotational testing as part of vestibular assessment.$18.64
92548Posturography, six-condition sensory organizationComputerized posturography may be part of the same broader balance evaluation.$53.14

How 92546 has changed in Washington, DC area

92546 · Office / nonfacility

$157.34

Effective 2026-10-01

The base rate is $5.94 higher than on 2025-10-01, moving from $151.40 to $157.34 (3.9%).

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

    $151.40changed to$157.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.29 changed to 0.28
    • Practice expense RVU 3.64 changed to 3.72
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $156.59changed to$151.40

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.66 changed to 3.64

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $154.04changed to$156.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $154.38changed to$154.04

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.47 changed to 3.66
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $156.49changed to$154.38

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.38 changed to 3.47
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $148.30changed to$156.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.16 changed to 3.38

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $137.07changed to$148.30

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.83 changed to 3.16
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $126.50changed to$137.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.63 changed to 2.83
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $126.79changed to$126.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.64 changed to 2.63

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $123.85changed to$126.79

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.58 changed to 2.64
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $124.03changed to$123.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.59 changed to 2.58
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $124.02changed to$124.03

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.02 changed to 0.03

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $123.40changed to$124.02

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $122.86changed to$123.40

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.58 changed to 2.59
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $126.47changed to$122.86

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.83 changed to 2.58
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $126.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$157.34Not available in this settingRVU26D
2026-07-01$157.34Not available in this settingRVU26C
2026-04-01$157.34Not available in this settingRVU26B
2026-01-01$157.34Not available in this settingRVU26A
2025-10-01$151.40Not available in this settingRVU25D
2025-07-01$151.40Not available in this settingRVU25C
2025-04-01$151.40Not available in this settingRVU25B
2025-01-01$151.40Not available in this settingRVU25A
2024-10-01$156.59Not available in this settingRVU24D
2024-07-01$156.59Not available in this settingRVU24C
2024-04-01$156.59Not available in this settingRVU24B
2024-03-09$156.59Not available in this settingRVU24AR
2024-01-01$154.04Not available in this settingRVU24A
2023-10-01$154.38Not available in this settingRVU23D
2023-07-01$154.38Not available in this settingRVU23C
2023-04-01$154.38Not available in this settingRVU23B
2023-01-01$154.38Not available in this settingRVU23A
2022-10-01$156.49Not available in this settingRVU22D
2022-07-01$156.49Not available in this settingRVU22C
2022-04-01$156.49Not available in this settingRVU22B
2022-01-01$156.49Not available in this settingRVU22A
2021-10-01$148.30Not available in this settingRVU21D
2021-07-01$148.30Not available in this settingRVU21C
2021-04-01$148.30Not available in this settingRVU21B
2021-01-01$148.30Not available in this settingRVU21A
2020-10-01$137.07Not available in this settingRVU20D
2020-07-01$137.07Not available in this settingRVU20C
2020-04-01$137.07Not available in this settingRVU20B
2020-01-01$137.07Not available in this settingRVU20A
2019-10-01$126.50Not available in this settingRVU19D
2019-07-01$126.50Not available in this settingRVU19C
2019-04-01$126.50Not available in this settingRVU19B
2019-01-01$126.50Not available in this settingRVU19A
2018-10-01$126.79Not available in this settingRVU18D
2018-07-01$126.79Not available in this settingRVU18C
2018-04-01$126.79Not available in this settingRVU18B
2018-01-01$126.79Not available in this settingRVU18AR1
2017-10-01$123.85Not available in this settingRVU17D
2017-07-01$123.85Not available in this settingRVU17C
2017-04-01$123.85Not available in this settingRVU17B
2017-01-01$123.85Not available in this settingRVU17A
2016-10-01$124.03Not available in this settingRVU16D
2016-07-01$124.03Not available in this settingRVU16C
2016-04-01$124.03Not available in this settingRVU16B
2016-01-01$124.03Not available in this settingRVU16A
2015-10-01$124.02Not available in this settingRVU15D
2015-07-01$124.02Not available in this settingRVU15C
2015-04-01$123.40Not available in this settingRVU15B
2015-01-01$123.40Not available in this settingRVU15A
2014-10-01$122.86Not available in this settingRVU14D
2014-07-01$122.86Not available in this settingRVU14C
2014-04-01$122.86Not available in this settingRVU14B
2014-01-01$122.86Not available in this settingRVU14A
2013-10-01$126.47Not available in this settingRVU13D
2013-07-01$126.47Not available in this settingRVU13C
2013-04-01$126.47Not available in this settingRVU13B
2013-01-01$126.47Not available in this settingRVU13AR

Price 92546 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

92546 billing questions

How is 92546 different from 92545?

92546 evaluates eye responses during chair rotation. 92545 evaluates eye tracking of a moving visual target.

Can 92546 be reported with 92540?

92540 represents a basic vestibular evaluation with specified eye-movement tests. Report 92546 separately when sinusoidal chair rotation is also performed and documented.

When should modifier 26 or TC be used?

Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Submit without either modifier for the global service.

What documentation supports 92546?

Document the reason for testing, the rotational test performed, the recorded eye-movement response, and the interpretation.

Is rotational testing the same as caloric testing?

No. Rotational testing measures responses during chair movement, while caloric testing stimulates the vestibular system through ear irrigation.

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 92546PPRRVU2026_Oct_nonQPP.csv, line 11,818 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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