CPT code 92550: Middle-ear testing, tympanometry and reflex thresholds2026 Medicare rate & RVUs in Virginia
Reports tympanometry together with acoustic reflex threshold testing to assess middle-ear function, commonly during evaluation of hearing loss or suspected middle-ear dysfunction.
In Virginia, Medicare pays $21.45 for 92550 in the office.
Check a contract rate as a % of Medicare · 92550 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 92550 covers
This service combines tympanometry, which measures middle-ear response to changes in ear-canal pressure, with acoustic reflex threshold testing, which checks the sound level that elicits a middle-ear muscle reflex. Audiologists commonly perform it in an audiology clinic or ENT practice when assessing hearing loss, abnormal middle-ear findings, or suspected eustachian tube or middle-ear dysfunction. Results help characterize middle-ear function alongside other hearing test findings.
Report 92550 when both tympanometry and reflex threshold measurements are performed; use a single-component code when only one of those tests is done. The record should identify the clinical reason for testing and include the findings for the measures performed. CMS prices this code as bilateral, so modifier 50 does not increase payment. The professional component modifier does not apply; do not split the service into professional and technical claims using modifier 26.
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 Virginia compares for 92550
Across 109 of 109 payment localities, the office rate for 92550 runs from $20.18 in Arkansas to $28.04 in Alaska. Virginia pays $21.45. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$21.45
- Los Angeles, CA · California$23.85+$2.40
- Washington, DC area · District of Columbia$24.10+$2.65
- Miami, FL · Florida$22.62+$1.17
- Chicago, IL · Illinois$22.27+$0.82
- Manhattan, NY · New York$24.22+$2.77
- Alaska · Alaska$28.04+$6.59
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $20.35 | — |
| ArkansasArkansas | $20.18 | — |
| ArizonaArizona | $21.36 | — |
| Bakersfield, CACalifornia | $22.73 | — |
| Chico, CACalifornia | $22.68 | — |
| El Centro, CACalifornia | $22.69 | — |
| Fresno, CACalifornia | $22.68 | — |
| Hanford, CACalifornia | $22.68 | — |
| Madera, CACalifornia | $22.68 | — |
| Merced, CACalifornia | $22.68 | — |
| Modesto, CACalifornia | $22.68 | — |
| Napa, CACalifornia | $25.36 | — |
| Oxnard, CACalifornia | $23.67 | — |
| Redding, CACalifornia | $22.68 | — |
| Rest of CaliforniaCalifornia | $22.68 | — |
| Riverside, CACalifornia | $22.80 | — |
| Sacramento, CACalifornia | $23.56 | — |
| Salinas, CACalifornia | $23.46 | — |
| San Diego, CACalifornia | $23.81 | — |
| Marin County, CACalifornia | $26.61 | — |
| San Francisco, CACalifornia | $26.60 | — |
| San Benito County, CACalifornia | $27.12 | — |
| Santa Clara County, CACalifornia | $27.08 | — |
| San Luis Obispo, CACalifornia | $23.10 | — |
| Santa Cruz, CACalifornia | $23.88 | — |
| Santa Maria, CACalifornia | $23.49 | — |
| Santa Rosa, CACalifornia | $24.11 | — |
| Stockton, CACalifornia | $22.68 | — |
| Vallejo, CACalifornia | $25.35 | — |
| Visalia, CACalifornia | $22.68 | — |
| Yuba City, CACalifornia | $22.68 | — |
| ColoradoColorado | $22.40 | — |
| ConnecticutConnecticut | $22.76 | — |
| DelawareDelaware | $21.62 | — |
| Fort Lauderdale, FLFlorida | $22.11 | — |
| Rest of FloridaFlorida | $21.45 | — |
| Atlanta, GAGeorgia | $21.97 | — |
| Rest of GeorgiaGeorgia | $20.73 | — |
| Hawaii, Guam, HIHawaii | $22.90 | — |
| IowaIowa | $20.69 | — |
| IdahoIdaho | $20.76 | — |
| East St. Louis, ILIllinois | $21.27 | — |
| Rest of IllinoisIllinois | $21.06 | — |
| Suburban Chicago, ILIllinois | $22.31 | — |
| IndianaIndiana | $20.83 | — |
| KansasKansas | $20.62 | — |
| KentuckyKentucky | $20.61 | — |
| New Orleans, LALouisiana | $21.18 | — |
| Rest of LouisianaLouisiana | $20.58 | — |
| Metropolitan Boston, MAMassachusetts | $24.03 | — |
| Rest of MassachusettsMassachusetts | $22.34 | — |
| Baltimore area, MDMaryland | $22.68 | — |
| Rest of MarylandMaryland | $21.92 | — |
| Rest of MaineMaine | $20.81 | — |
| Southern Maine, MEMaine | $21.50 | — |
| Detroit, MIMichigan | $21.60 | — |
| Rest of MichiganMichigan | $20.91 | — |
| MinnesotaMinnesota | $21.76 | — |
| Metropolitan Kansas City, MOMissouri | $21.11 | — |
| Metropolitan St. Louis, MOMissouri | $21.25 | — |
| Rest of MissouriMissouri | $20.37 | — |
| MississippiMississippi | $20.28 | — |
| MontanaMontana | $21.71 | — |
| North CarolinaNorth Carolina | $20.94 | — |
| North DakotaNorth Dakota | $21.51 | — |
| NebraskaNebraska | $20.76 | — |
| New HampshireNew Hampshire | $22.07 | — |
| Northern New JerseyNew Jersey | $24.02 | — |
| Rest of New JerseyNew Jersey | $23.10 | — |
| New MexicoNew Mexico | $20.97 | — |
| NevadaNevada | $21.66 | — |
| NYC suburbs and Long Island, NYNew York | $24.58 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $23.23 | — |
| Queens, NYNew York | $24.37 | — |
| Rest of New YorkNew York | $21.13 | — |
| OhioOhio | $20.87 | — |
| OklahomaOklahoma | $20.60 | — |
| Portland, OROregon | $22.89 | — |
| Rest of OregonOregon | $21.57 | — |
| Metropolitan Philadelphia, PAPennsylvania | $22.38 | — |
| Rest of PennsylvaniaPennsylvania | $20.90 | — |
| Puerto RicoPuerto Rico | $21.81 | — |
| Rhode IslandRhode Island | $22.22 | — |
| South CarolinaSouth Carolina | $20.92 | — |
| South DakotaSouth Dakota | $21.49 | — |
| TennesseeTennessee | $20.67 | — |
| Austin, TXTexas | $22.26 | — |
| Beaumont, TXTexas | $20.82 | — |
| Brazoria, TXTexas | $21.64 | — |
| Dallas, TXTexas | $21.73 | — |
| Fort Worth, TXTexas | $21.64 | — |
| Galveston, TXTexas | $21.68 | — |
| Houston, TXTexas | $21.86 | — |
| Rest of TexasTexas | $21.18 | — |
| UtahUtah | $21.10 | — |
| Virgin Islands, VIUnited States Virgin Islands | $21.81 | — |
| VermontVermont | $21.45 | — |
| Rest of WashingtonWashington | $22.30 | — |
| King County, WAWashington | $24.43 | — |
| WisconsinWisconsin | $21.07 | — |
| West VirginiaWest Virginia | $20.59 | — |
| WyomingWyoming | $21.62 | — |
92550 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.
$20.18
$28.04
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 | $28.04 | 1 |
| AL | $20.35 | 1 |
| AR | $20.18 | 1 |
| AZ | $21.36 | 1 |
| CA | $22.68–$27.12 | 29 |
| CO | $22.40 | 1 |
| CT | $22.76 | 1 |
| DC | $24.10 | 1 |
| DE | $21.62 | 1 |
| FL | $21.45–$22.62 | 3 |
| GA | $20.73–$21.97 | 2 |
| GU | $22.90 | 1 |
| HI | $22.90 | 1 |
| IA | $20.69 | 1 |
| ID | $20.76 | 1 |
| IL | $21.06–$22.31 | 4 |
| IN | $20.83 | 1 |
| KS | $20.62 | 1 |
| KY | $20.61 | 1 |
| LA | $20.58–$21.18 | 2 |
| MA | $22.34–$24.03 | 2 |
| MD | $21.92–$24.10 | 3 |
| ME | $20.81–$21.50 | 2 |
| MI | $20.91–$21.60 | 2 |
| MN | $21.76 | 1 |
| MO | $20.37–$21.25 | 3 |
| MS | $20.28 | 1 |
| MT | $21.71 | 1 |
| NC | $20.94 | 1 |
| ND | $21.51 | 1 |
| NE | $20.76 | 1 |
| NH | $22.07 | 1 |
| NJ | $23.10–$24.02 | 2 |
| NM | $20.97 | 1 |
| NV | $21.66 | 1 |
| NY | $21.13–$24.58 | 5 |
| OH | $20.87 | 1 |
| OK | $20.60 | 1 |
| OR | $21.57–$22.89 | 2 |
| PA | $20.90–$22.38 | 2 |
| PR | $21.81 | 1 |
| RI | $22.22 | 1 |
| SC | $20.92 | 1 |
| SD | $21.49 | 1 |
| TN | $20.67 | 1 |
| TX | $20.82–$22.26 | 8 |
| UT | $21.10 | 1 |
| VA | $21.45–$24.10 | 2 |
| VI | $21.81 | 1 |
| VT | $21.45 | 1 |
| WA | $22.30–$24.43 | 2 |
| WI | $21.07 | 1 |
| WV | $20.59 | 1 |
| WY | $21.62 | 1 |
How the 92550 rate is calculated
Each of 92550’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 · 92550
RVUs × geographic indexes × conversion factor
Work0.35
0.35 RVUs× 1.000 GPCI
Practice expense0.29
0.29 RVUs× 1.000 GPCI
Malpractice0.01
0.01 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 Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,828
- Code
- 92550
- Physician work
- 0.35
- Practice expense
- 0.29
- Malpractice
- 0.01
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.35 | × 1.000 | 0.3500 |
| Practice expense | 0.29 | × 0.983 | 0.2851 |
| Malpractice | 0.01 | × 0.706 | 0.0071 |
| Total RVUs | 0.6421 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$21.45
Office: (0.35 × 1 + 0.29 × 0.983 + 0.01 × 0.706) × $33.4009 = $21.45
Payment rules and modifiers for 92550
The CMS indicators that decide how 92550 is paid alongside other services.
CMS payment indicators · 92550
Middle-ear testing, tympanometry and reflex thresholds
| 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 | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
92550 without CQ · national office
$21.71
Middle-ear testing, tympanometry and reflex thresholds
92550-CQ · Allowed amount unchanged
$21.71
Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.
How 92550 has changed in Virginia
92550 · Office / nonfacility
$21.45
Effective 2026-10-01
The base rate is $0.63 higher than on 2025-10-01, moving from $20.82 to $21.45 (3.0%).
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
$20.82changed to$21.45
- Conversion factor 32.3465 changed to 33.4009
- Work GPCI 1.002 changed to 1.000
- Practice expense GPCI 0.984 changed to 0.983
- Malpractice GPCI 0.755 changed to 0.706
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$21.42changed to$20.82
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$21.07changed to$21.42
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$22.20changed to$21.07
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.30 changed to 0.29
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 0.990 changed to 0.984
- Malpractice GPCI 0.826 changed to 0.755
January 1, 2023
RVU23A
$22.72changed to$22.20
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.29 changed to 0.30
- Malpractice RVU 0.02 changed to 0.01
- Practice expense GPCI 0.995 changed to 0.990
- Malpractice GPCI 0.897 changed to 0.826
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$22.56changed to$22.72
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.28 changed to 0.29
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$22.58changed to$22.56
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.26 changed to 0.28
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.903 changed to 0.897
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$22.15changed to$22.58
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.25 changed to 0.26
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.908 changed to 0.903
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$21.77changed to$22.15
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.24 changed to 0.25
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$21.31changed to$21.77
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.23 changed to 0.24
- Practice expense GPCI 0.985 changed to 0.986
- Malpractice GPCI 0.866 changed to 0.908
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$21.22changed to$21.31
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.983 changed to 0.985
- Malpractice GPCI 0.824 changed to 0.866
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$21.00changed to$21.22
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.01 changed to 0.02
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$20.89changed to$21.00
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$20.89changed to$20.89
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 0.980 changed to 0.983
- Malpractice GPCI 0.778 changed to 0.824
Held through RVU15B.
January 1, 2014
RVU14A
$20.47changed to$20.89
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.25 changed to 0.23
- Practice expense GPCI 0.977 changed to 0.980
- Malpractice GPCI 0.731 changed to 0.778
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $20.47
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $21.45 | Not available in this setting | RVU26D |
| 2026-07-01 | $21.45 | Not available in this setting | RVU26C |
| 2026-04-01 | $21.45 | Not available in this setting | RVU26B |
| 2026-01-01 | $21.45 | Not available in this setting | RVU26A |
| 2025-10-01 | $20.82 | Not available in this setting | RVU25D |
| 2025-07-01 | $20.82 | Not available in this setting | RVU25C |
| 2025-04-01 | $20.82 | Not available in this setting | RVU25B |
| 2025-01-01 | $20.82 | Not available in this setting | RVU25A |
| 2024-10-01 | $21.42 | Not available in this setting | RVU24D |
| 2024-07-01 | $21.42 | Not available in this setting | RVU24C |
| 2024-04-01 | $21.42 | Not available in this setting | RVU24B |
| 2024-03-09 | $21.42 | Not available in this setting | RVU24AR |
| 2024-01-01 | $21.07 | Not available in this setting | RVU24A |
| 2023-10-01 | $22.20 | Not available in this setting | RVU23D |
| 2023-07-01 | $22.20 | Not available in this setting | RVU23C |
| 2023-04-01 | $22.20 | Not available in this setting | RVU23B |
| 2023-01-01 | $22.20 | Not available in this setting | RVU23A |
| 2022-10-01 | $22.72 | Not available in this setting | RVU22D |
| 2022-07-01 | $22.72 | Not available in this setting | RVU22C |
| 2022-04-01 | $22.72 | Not available in this setting | RVU22B |
| 2022-01-01 | $22.72 | Not available in this setting | RVU22A |
| 2021-10-01 | $22.56 | Not available in this setting | RVU21D |
| 2021-07-01 | $22.56 | Not available in this setting | RVU21C |
| 2021-04-01 | $22.56 | Not available in this setting | RVU21B |
| 2021-01-01 | $22.56 | Not available in this setting | RVU21A |
| 2020-10-01 | $22.58 | Not available in this setting | RVU20D |
| 2020-07-01 | $22.58 | Not available in this setting | RVU20C |
| 2020-04-01 | $22.58 | Not available in this setting | RVU20B |
| 2020-01-01 | $22.58 | Not available in this setting | RVU20A |
| 2019-10-01 | $22.15 | Not available in this setting | RVU19D |
| 2019-07-01 | $22.15 | Not available in this setting | RVU19C |
| 2019-04-01 | $22.15 | Not available in this setting | RVU19B |
| 2019-01-01 | $22.15 | Not available in this setting | RVU19A |
| 2018-10-01 | $21.77 | Not available in this setting | RVU18D |
| 2018-07-01 | $21.77 | Not available in this setting | RVU18C |
| 2018-04-01 | $21.77 | Not available in this setting | RVU18B |
| 2018-01-01 | $21.77 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $21.31 | Not available in this setting | RVU17D |
| 2017-07-01 | $21.31 | Not available in this setting | RVU17C |
| 2017-04-01 | $21.31 | Not available in this setting | RVU17B |
| 2017-01-01 | $21.31 | Not available in this setting | RVU17A |
| 2016-10-01 | $21.22 | Not available in this setting | RVU16D |
| 2016-07-01 | $21.22 | Not available in this setting | RVU16C |
| 2016-04-01 | $21.22 | Not available in this setting | RVU16B |
| 2016-01-01 | $21.22 | Not available in this setting | RVU16A |
| 2015-10-01 | $21.00 | Not available in this setting | RVU15D |
| 2015-07-01 | $21.00 | Not available in this setting | RVU15C |
| 2015-04-01 | $20.89 | Not available in this setting | RVU15B |
| 2015-01-01 | $20.89 | Not available in this setting | RVU15A |
| 2014-10-01 | $20.89 | Not available in this setting | RVU14D |
| 2014-07-01 | $20.89 | Not available in this setting | RVU14C |
| 2014-04-01 | $20.89 | Not available in this setting | RVU14B |
| 2014-01-01 | $20.89 | Not available in this setting | RVU14A |
| 2013-10-01 | $20.47 | Not available in this setting | RVU13D |
| 2013-07-01 | $20.47 | Not available in this setting | RVU13C |
| 2013-04-01 | $20.47 | Not available in this setting | RVU13B |
| 2013-01-01 | $20.47 | Not available in this setting | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
92550 billing questions
When should 92550 be reported instead of 92567?
Report 92550 when tympanometry and acoustic reflex threshold testing are both performed. Use 92567 when the service is tympanometry alone.
Can the reflex threshold test be billed separately with 92550?
92550 combines tympanometry and reflex threshold testing. Do not separately report the reflex measurement for the same work.
Should modifier 50 be appended when both ears are tested?
No. CMS prices 92550 as bilateral, and modifier 50 does not increase payment.
Can modifier 26 be used for the interpretation?
No. The CMS component rule states that the professional component modifier does not apply to this service.
What documentation supports reporting 92550?
Document the reason for testing and findings for both the tympanometry and acoustic reflex threshold measures 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
Show the CMS file lines behind this rate
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