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CPT code 92557: Comprehensive hearing test, air, bone, and speech testing2026 Medicare rate & RVUs in North Dakota

Diagnostic hearing evaluation combining air and bone conduction thresholds with speech reception and word recognition testing, reported as one bilateral service.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3M Medicare services in 2024

In North Dakota, Medicare pays $35.54 for 92557 in the office and $25.52 when it’s performed in a hospital or facility.

$35.54Office (non-facility)
$25.52Hospital or facility
−0.6%vs the national office rate ($35.74)

Check a contract rate as a % of Medicare · 92557 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 92557 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 92557 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 92557 covers

This diagnostic audiogram measures pure tone air and bone conduction thresholds across test frequencies, with masking when needed. It also measures a speech reception threshold and word recognition at levels above that threshold. Audiologists typically perform the testing in a sound booth at an ENT practice, hospital outpatient audiology department, or audiology clinic. Common indications include suspected hearing loss, tinnitus, asymmetric hearing loss, sudden hearing loss, and monitoring for ototoxic effects.

Report one unit when the pure tone and complete speech portions are performed for both ears. The record should show the air and bone thresholds, speech reception thresholds, word recognition scores, any masking used, and interpretation. Do not separately report 92553 or 92556 for testing included in 92557. CMS identifies this as a therapy service for which the professional component modifier does not apply, so modifier 26 is not used to bill an interpretation alone. CMS prices the service as bilateral; modifier 50 does not increase payment. If testing is limited to one ear, report the reduced service with modifier 52.

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 North Dakota compares for 92557

Across 109 of 109 payment localities, the office rate for 92557 runs from $33.41 in Arkansas to $46.61 in Alaska. North Dakota pays $35.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

92557 in North Dakota vs other payment areas
  1. North Dakota · this page$35.54
  2. Los Angeles, CA · California$39.26+$3.72
  3. Washington, DC area · District of Columbia$39.59+$4.05
  4. Miami, FL · Florida$36.88+$1.34
  5. Chicago, IL · Illinois$36.39+$0.85
  6. Manhattan, NY · New York$39.71+$4.17
  7. Alaska · Alaska$46.61+$11.07

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

92557 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$33.67$24.91
ArkansasArkansas$33.41$24.80
ArizonaArizona$35.21$25.50
Bakersfield, CACalifornia$37.46$26.48
Chico, CACalifornia$37.40$26.42
El Centro, CACalifornia$37.40$26.42
Fresno, CACalifornia$37.40$26.42
Hanford, CACalifornia$37.40$26.42

92557 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.

$33.41

$46.61

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

View every state and territory as a table
92557 office rate range by state
State / territoryOffice rate rangeLocalities
AK$46.611
AL$33.671
AR$33.411
AZ$35.211
CA$37.40–$44.5829
CO$36.891
CT$37.391
DC$39.591
DE$35.621
FL$35.23–$36.883
GA$34.14–$36.112
GU$37.701
HI$37.701
IA$34.231
ID$34.331
IL$34.59–$36.554
IN$34.451
KS$34.101
KY$34.011
LA$33.96–$34.882
MA$36.81–$39.502
MD$36.10–$39.593
ME$34.38–$35.482
MI$34.45–$35.432
MN$35.951
MO$33.61–$35.003
MS$33.521
MT$35.741
NC$34.591
ND$35.541
NE$34.351
NH$36.331
NJ$37.99–$39.482
NM$34.531
NV$35.701
NY$34.87–$40.215
OH$34.401
OK$34.021
OR$35.58–$37.682
PA$34.46–$36.792
PR$35.901
RI$36.591
SC$34.521
SD$35.521
TN$34.191
TX$34.33–$36.638
UT$34.781
VA$35.38–$39.592
VI$35.901
VT$35.421
WA$36.73–$40.172
WI$34.861
WV$33.871
WY$35.651

See 92557 in every payment locality

How the 92557 rate is calculated

Each of 92557’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 · 92557

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.60

0.60 RVUs× 1.000 GPCI

Practice expense0.46

0.46 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

1.0700

Conversion factor

$33.4009

Medicare rate

$35.74

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

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,834

Code
92557
Physician work
0.60
Practice expense
0.46
Malpractice
0.01

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 92557 in North Dakota
ComponentRVULocality factorAdjusted
Physician work0.60× 1.0000.6000
Practice expense0.46× 1.0000.4600
Malpractice0.01× 0.4060.0041
Total RVUs1.0641
Conversion factor× 33.4009

Office rate, North Dakota$35.54

Office: (0.6 × 1 + 0.46 × 1 + 0.01 × 0.406) × $33.4009 = $35.54

Facility: (0.6 × 1 + 0.16 × 1 + 0.01 × 0.406) × $33.4009 = $25.52

Open 92557 in the RVU calculator

Payment rules and modifiers for 92557

The CMS indicators that decide how 92557 is paid alongside other services.

CMS payment indicators · 92557

Comprehensive hearing test, air, bone, and speech testing

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

92557 without CQ · national office

$35.74

Comprehensive hearing test, air, bone, and speech testing

92557-CQ · Allowed amount unchanged

$35.74

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.

Codes related to 92557

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

Codes related to 92557
CodeHow it relatesOffice range, North Dakota
Same family
92553Audiometry, air and bone thresholdsAir and bone pure tone thresholds only, without the speech audiometry portion.$48.90
92556Speech audiometry, with speech recognitionComplete speech audiometry alone, without pure tone threshold testing.$46.23
92552Pure-tone audiometry, air conduction onlyAir conduction pure tone thresholds only; included when this comprehensive test is performed.$40.22
92555Speech audiometry, threshold onlySpeech threshold only, without word recognition; included in the comprehensive test.$29.53
Often billed with
92550Middle-ear testing, tympanometry and reflex thresholdsTympanometry with acoustic reflex thresholds may be performed at the same audiology visit.$21.51
92567Tympanometry, middle ear pressure and mobilityTympanometry alone may assess middle ear function alongside the audiogram.$15.83
92570Immittance testing, tympanometry and reflex measuresImmittance testing with reflex threshold and decay measures may accompany the comprehensive audiogram.$31.20
Used instead
92551Hearing screening, pure tone, air onlyAir-only pure tone screening when a screening test, rather than diagnostic audiometry, is needed.No office rate

How 92557 has changed in North Dakota

92557 · Office / nonfacility

$35.54

Effective 2026-10-01

The base rate is $0.59 higher than on 2025-10-01, moving from $34.95 to $35.54 (1.7%).

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

    $34.95changed to$35.54

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.47 changed to 0.46
    • Malpractice RVU 0.02 changed to 0.01
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $35.96changed to$34.95

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $35.37changed to$35.96

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $36.92changed to$35.37

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.48 changed to 0.47
    • Malpractice GPCI 0.474 changed to 0.517

  5. January 1, 2023

    RVU23A

    $37.63changed to$36.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.47 changed to 0.48
    • Malpractice RVU 0.04 changed to 0.02
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $38.29changed to$37.63

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.48 changed to 0.47

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $38.42changed to$38.29

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.45 changed to 0.48
    • Malpractice RVU 0.03 changed to 0.04
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $38.42changed to$38.42

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $38.02changed to$38.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.44 changed to 0.45

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $37.91changed to$38.02

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $37.47changed to$37.91

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.43 changed to 0.44
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $37.41changed to$37.47

    • 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

    $37.22changed to$37.41

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $37.47changed to$37.22

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.03 changed to 0.02
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $36.93changed to$37.47

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.47 changed to 0.43
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $36.93

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$35.54$25.52RVU26D
2026-07-01$35.54$25.52RVU26C
2026-04-01$35.54$25.52RVU26B
2026-01-01$35.54$25.52RVU26A
2025-10-01$34.95$30.42RVU25D
2025-07-01$34.95$30.42RVU25C
2025-04-01$34.95$30.42RVU25B
2025-01-01$34.95$30.42RVU25A
2024-10-01$35.96$30.97RVU24D
2024-07-01$35.96$30.97RVU24C
2024-04-01$35.96$30.97RVU24B
2024-03-09$35.96$30.97RVU24AR
2024-01-01$35.37$30.46RVU24A
2023-10-01$36.92$31.50RVU23D
2023-07-01$36.92$31.50RVU23C
2023-04-01$36.92$31.50RVU23B
2023-01-01$36.92$31.50RVU23A
2022-10-01$37.63$32.09RVU22D
2022-07-01$37.63$32.09RVU22C
2022-04-01$37.63$32.09RVU22B
2022-01-01$37.63$32.09RVU22A
2021-10-01$38.29$32.35RVU21D
2021-07-01$38.29$32.35RVU21C
2021-04-01$38.29$32.35RVU21B
2021-01-01$38.29$32.35RVU21A
2020-10-01$38.42$33.01RVU20D
2020-07-01$38.42$33.01RVU20C
2020-04-01$38.42$33.01RVU20B
2020-01-01$38.42$33.01RVU20A
2019-10-01$38.42$33.02RVU19D
2019-07-01$38.42$33.02RVU19C
2019-04-01$38.42$33.02RVU19B
2019-01-01$38.42$33.02RVU19A
2018-10-01$38.02$32.98RVU18D
2018-07-01$38.02$32.98RVU18C
2018-04-01$38.02$32.98RVU18B
2018-01-01$38.02$32.98RVU18AR1
2017-10-01$37.91$32.89RVU17D
2017-07-01$37.91$32.89RVU17C
2017-04-01$37.91$32.89RVU17B
2017-01-01$37.91$32.89RVU17A
2016-10-01$37.47$32.82RVU16D
2016-07-01$37.47$32.82RVU16C
2016-04-01$37.47$32.82RVU16B
2016-01-01$37.47$32.82RVU16A
2015-10-01$37.41$32.38RVU15D
2015-07-01$37.41$32.38RVU15C
2015-04-01$37.22$32.22RVU15B
2015-01-01$37.22$32.22RVU15A
2014-10-01$37.47$32.46RVU14D
2014-07-01$37.47$32.46RVU14C
2014-04-01$37.47$32.46RVU14B
2014-01-01$37.47$32.46RVU14A
2013-10-01$36.93$31.49RVU13D
2013-07-01$36.93$31.49RVU13C
2013-04-01$36.93$31.49RVU13B
2013-01-01$36.93$31.49RVU13AR

Price 92557 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

92557 billing questions

Can 92553 or 92556 be billed with 92557 for the same testing?

No. 92557 combines air and bone pure tone audiometry with complete speech audiometry. Reporting either component code for those same tests would duplicate the service.

Should modifier 50 or RT/LT be added when both ears are tested?

No. One unit of 92557 represents bilateral testing, and CMS states that modifier 50 does not increase payment.

What if only one ear could be tested?

Append modifier 52 to indicate that the bilateral service was reduced to testing one ear. Document which ear was tested and why the other ear was not.

Is tympanometry included?

No. Tympanometry is separate; depending on the immittance measures performed, 92550, 92567, or 92570 may be reported at the same visit.

Can modifier 26 be used when a physician interprets an audiogram performed elsewhere?

No. CMS identifies 92557 as a therapy service for which the professional component modifier does not apply; an interpretation alone is not billed as 92557-26.

What if speech testing is not completed?

If only air and bone thresholds are obtained, report 92553 instead. Complete speech audiometry, including speech reception threshold and word recognition, is needed for 92557.

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 92557PPRRVU2026_Oct_nonQPP.csv, line 11,834 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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