CPT code 92568: Acoustic reflex, threshold measurement2026 Medicare rate & RVUs in Maryland
Reports measurement of the sound level that triggers an acoustic reflex, typically during diagnostic evaluation of hearing or middle-ear function.
Medicare pays $15.50–$16.88 for 92568 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 92568 covers
An audiologist typically uses immittance equipment to measure the sound level that elicits an involuntary middle-ear muscle response. The test may be included in an outpatient diagnostic hearing evaluation when reflex thresholds help interpret auditory or middle-ear findings. Results are recorded by ear and can be considered alongside tympanometry and audiometry.
Report 92568 for the reflex-threshold measurement itself, rather than tympanometry alone or a broader immittance service that includes this measurement. Documentation should identify the ears tested, test conditions, measured thresholds or absent responses, and relevant interpretation. CMS prices the service on a bilateral basis, so modifier 50 does not increase payment. CMS identifies this as a therapy service; the professional component modifier does not apply.
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 92568 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$15.50 to $16.88
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $15.99 | $13.12 |
| Rest of Maryland | $15.50 | $12.79 |
| Washington, DC area | $16.88 | $13.73 |
How the 92568 rate is calculated
Each of 92568’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 · 92568
RVUs × geographic indexes × conversion factor
Work0.29
0.29 RVUs× 1.000 GPCI
Practice expense0.16
0.16 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.4600
Conversion factor
$33.4009
Medicare rate
$15.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92568
The CMS indicators that decide how 92568 is paid alongside other services.
CMS payment indicators · 92568
Acoustic reflex, threshold measurement
| 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
92568 without CQ · national office
$15.36
Acoustic reflex, threshold measurement
92568-CQ · Allowed amount unchanged
$15.36
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.
92568 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92567TympanometryMiddle ear pressure and mobility
- 92567 reports tympanometry, which evaluates middle-ear pressure and mobility. Use 92568 for measuring the sound level that triggers an acoustic reflex.
- 92550Middle-ear testingTympanometry and reflex thresholds
- 92550 combines tympanometry with reflex-threshold measurements. 92568 represents the reflex-threshold test rather than that combined service.
- 92570Immittance testingTympanometry and reflex measures
- 92570 covers a broader acoustic immittance service that includes reflex thresholds. 92568 is specific to the threshold measurement.
92568 billing questions
How is 92568 different from tympanometry?
92568 measures the sound level that elicits an acoustic reflex. Tympanometry, reported with 92567, assesses middle-ear pressure and mobility.
Should 92568 be reported with 92550?
92550 represents tympanometry together with reflex-threshold measurements. When both services are performed as that combined service, compare 92550 with reporting the individual tests.
How does 92568 differ from 92570?
92570 describes a broader acoustic immittance service that includes reflex-threshold measurement. Use 92568 when reporting the threshold test itself, rather than the broader service.
Should modifier 50 be appended?
CMS prices 92568 as bilateral. Modifier 50 does not increase payment.
Can modifier 26 be used for the professional work?
No. CMS identifies this as a therapy service for which the professional component modifier does not apply.
What should the record include?
Document the ears tested, test conditions, measured thresholds or absent responses, and the interpretation of the findings.
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
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