CPT code 92570: Immittance testing, tympanometry and reflex measures2026 Medicare rate & RVUs in Puerto Rico
Reports a comprehensive middle-ear test battery combining tympanometry with acoustic reflex measurements when evaluating hearing or middle-ear disorders.
In Puerto Rico, Medicare pays $31.53 for 92570 in the office and $23.76 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 92570 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 92570 covers
An audiologist or other qualified hearing professional uses acoustic immittance testing to assess eardrum and middle-ear mobility and measure acoustic reflex responses. The battery includes tympanometry, reflex threshold testing, and reflex decay testing. It is commonly performed in audiology and otolaryngology settings when evaluating conductive hearing loss, middle-ear fluid or pressure problems, or other abnormal hearing findings.
Report 92570 when the documented service includes the comprehensive immittance battery, rather than only one of its component test types. Retain the test results and clinical rationale showing which measurements were performed. CMS treats this as a service without a separately billable professional component, so modifier 26 does not apply. The code is priced as bilateral; modifier 50 does not increase payment.
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 Puerto Rico compares for 92570
Across 109 of 109 payment localities, the office rate for 92570 runs from $29.45 in Arkansas to $41.26 in Alaska. Puerto Rico pays $31.53. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$31.53
- Los Angeles, CA · California$34.36+$2.83
- Washington, DC area · District of Columbia$34.69+$3.16
- Miami, FL · Florida$32.43+$0.90
- Chicago, IL · Illinois$32.02+$0.49
- Manhattan, NY · New York$34.82+$3.29
- Alaska · Alaska$41.26+$9.73
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $29.67 | $22.94 |
| ArkansasArkansas | $29.45 | $22.85 |
| ArizonaArizona | $30.96 | $23.51 |
| Bakersfield, CACalifornia | $32.83 | $24.41 |
| Chico, CACalifornia | $32.77 | $24.35 |
| El Centro, CACalifornia | $32.77 | $24.35 |
| Fresno, CACalifornia | $32.77 | $24.35 |
| Hanford, CACalifornia | $32.77 | $24.35 |
| Madera, CACalifornia | $32.77 | $24.35 |
| Merced, CACalifornia | $32.77 | $24.35 |
| Modesto, CACalifornia | $32.77 | $24.35 |
| Napa, CACalifornia | $36.43 | $26.30 |
| Oxnard, CACalifornia | $34.10 | $25.01 |
| Redding, CACalifornia | $32.77 | $24.35 |
| Rest of CaliforniaCalifornia | $32.77 | $24.35 |
| Riverside, CACalifornia | $32.90 | $24.48 |
| Sacramento, CACalifornia | $33.97 | $25.04 |
| Salinas, CACalifornia | $33.83 | $24.93 |
| San Diego, CACalifornia | $34.28 | $25.09 |
| Marin County, CACalifornia | $38.17 | $27.33 |
| San Francisco, CACalifornia | $38.15 | $27.32 |
| San Benito County, CACalifornia | $38.87 | $27.79 |
| Santa Clara County, CACalifornia | $38.83 | $27.75 |
| San Luis Obispo, CACalifornia | $33.32 | $24.57 |
| Santa Cruz, CACalifornia | $34.36 | $25.02 |
| Santa Maria, CACalifornia | $33.86 | $24.91 |
| Santa Rosa, CACalifornia | $34.69 | $25.25 |
| Stockton, CACalifornia | $32.77 | $24.35 |
| Vallejo, CACalifornia | $36.41 | $26.28 |
| Visalia, CACalifornia | $32.77 | $24.35 |
| Yuba City, CACalifornia | $32.77 | $24.35 |
| ColoradoColorado | $32.36 | $24.18 |
| ConnecticutConnecticut | $32.81 | $24.54 |
| DelawareDelaware | $31.30 | $23.71 |
| Fort Lauderdale, FLFlorida | $31.83 | $24.05 |
| Rest of FloridaFlorida | $31.01 | $23.66 |
| Atlanta, GAGeorgia | $31.72 | $23.92 |
| Rest of GeorgiaGeorgia | $30.09 | $23.24 |
| Hawaii, Guam, HIHawaii | $33.00 | $24.26 |
| IowaIowa | $30.12 | $23.09 |
| IdahoIdaho | $30.21 | $23.14 |
| East St. Louis, ILIllinois | $30.72 | $23.65 |
| Rest of IllinoisIllinois | $30.48 | $23.47 |
| Suburban Chicago, ILIllinois | $32.13 | $24.24 |
| IndianaIndiana | $30.30 | $23.18 |
| KansasKansas | $30.01 | $23.07 |
| KentuckyKentucky | $29.96 | $23.13 |
| New Orleans, LALouisiana | $30.69 | $23.46 |
| Rest of LouisianaLouisiana | $29.92 | $23.12 |
| Metropolitan Boston, MAMassachusetts | $34.58 | $25.40 |
| Rest of MassachusettsMassachusetts | $32.30 | $24.21 |
| Baltimore area, MDMaryland | $32.70 | $24.45 |
| Rest of MarylandMaryland | $31.71 | $23.93 |
| Rest of MaineMaine | $30.26 | $23.19 |
| Southern Maine, MEMaine | $31.16 | $23.55 |
| Detroit, MIMichigan | $31.18 | $23.77 |
| Rest of MichiganMichigan | $30.34 | $23.32 |
| MinnesotaMinnesota | $31.53 | $23.62 |
| Metropolitan Kansas City, MOMissouri | $30.61 | $23.40 |
| Metropolitan St. Louis, MOMissouri | $30.79 | $23.47 |
| Rest of MissouriMissouri | $29.64 | $23.01 |
| MississippiMississippi | $29.55 | $22.93 |
| MontanaMontana | $31.40 | $23.71 |
| North CarolinaNorth Carolina | $30.43 | $23.26 |
| North DakotaNorth Dakota | $31.20 | $23.52 |
| NebraskaNebraska | $30.21 | $23.12 |
| New HampshireNew Hampshire | $31.88 | $23.88 |
| Northern New JerseyNew Jersey | $34.61 | $25.70 |
| Rest of New JerseyNew Jersey | $33.33 | $24.94 |
| New MexicoNew Mexico | $30.41 | $23.37 |
| NevadaNevada | $31.35 | $23.66 |
| NYC suburbs and Long Island, NYNew York | $35.26 | $26.12 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $33.50 | $25.09 |
| Queens, NYNew York | $35.03 | $25.95 |
| Rest of New YorkNew York | $30.66 | $23.36 |
| OhioOhio | $30.30 | $23.28 |
| OklahomaOklahoma | $29.96 | $23.10 |
| Portland, OROregon | $33.01 | $24.48 |
| Rest of OregonOregon | $31.25 | $23.60 |
| Metropolitan Philadelphia, PAPennsylvania | $32.31 | $24.32 |
| Rest of PennsylvaniaPennsylvania | $30.34 | $23.29 |
| Rhode IslandRhode Island | $32.13 | $24.19 |
| South CarolinaSouth Carolina | $30.38 | $23.28 |
| South DakotaSouth Dakota | $31.18 | $23.49 |
| TennesseeTennessee | $30.09 | $23.10 |
| Austin, TXTexas | $32.13 | $24.00 |
| Beaumont, TXTexas | $30.23 | $23.24 |
| Brazoria, TXTexas | $31.36 | $23.74 |
| Dallas, TXTexas | $31.46 | $23.81 |
| Fort Worth, TXTexas | $31.34 | $23.77 |
| Galveston, TXTexas | $31.40 | $23.77 |
| Houston, TXTexas | $31.58 | $23.95 |
| Rest of TexasTexas | $30.72 | $23.43 |
| UtahUtah | $30.60 | $23.38 |
| VirginiaVirginia | $31.08 | $23.53 |
| Virgin Islands, VIUnited States Virgin Islands | $31.53 | $23.76 |
| VermontVermont | $31.10 | $23.50 |
| Rest of WashingtonWashington | $32.23 | $24.14 |
| King County, WAWashington | $35.14 | $25.71 |
| WisconsinWisconsin | $30.63 | $23.27 |
| West VirginiaWest Virginia | $29.88 | $23.20 |
| WyomingWyoming | $31.31 | $23.63 |
92570 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.
$29.45
$41.26
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 | $41.26 | 1 |
| AL | $29.67 | 1 |
| AR | $29.45 | 1 |
| AZ | $30.96 | 1 |
| CA | $32.77–$38.87 | 29 |
| CO | $32.36 | 1 |
| CT | $32.81 | 1 |
| DC | $34.69 | 1 |
| DE | $31.30 | 1 |
| FL | $31.01–$32.43 | 3 |
| GA | $30.09–$31.72 | 2 |
| GU | $33.00 | 1 |
| HI | $33.00 | 1 |
| IA | $30.12 | 1 |
| ID | $30.21 | 1 |
| IL | $30.48–$32.13 | 4 |
| IN | $30.30 | 1 |
| KS | $30.01 | 1 |
| KY | $29.96 | 1 |
| LA | $29.92–$30.69 | 2 |
| MA | $32.30–$34.58 | 2 |
| MD | $31.71–$34.69 | 3 |
| ME | $30.26–$31.16 | 2 |
| MI | $30.34–$31.18 | 2 |
| MN | $31.53 | 1 |
| MO | $29.64–$30.79 | 3 |
| MS | $29.55 | 1 |
| MT | $31.40 | 1 |
| NC | $30.43 | 1 |
| ND | $31.20 | 1 |
| NE | $30.21 | 1 |
| NH | $31.88 | 1 |
| NJ | $33.33–$34.61 | 2 |
| NM | $30.41 | 1 |
| NV | $31.35 | 1 |
| NY | $30.66–$35.26 | 5 |
| OH | $30.30 | 1 |
| OK | $29.96 | 1 |
| OR | $31.25–$33.01 | 2 |
| PA | $30.34–$32.31 | 2 |
| PR | $31.53 | 1 |
| RI | $32.13 | 1 |
| SC | $30.38 | 1 |
| SD | $31.18 | 1 |
| TN | $30.09 | 1 |
| TX | $30.23–$32.13 | 8 |
| UT | $30.60 | 1 |
| VA | $31.08–$34.69 | 2 |
| VI | $31.53 | 1 |
| VT | $31.10 | 1 |
| WA | $32.23–$35.14 | 2 |
| WI | $30.63 | 1 |
| WV | $29.88 | 1 |
| WY | $31.31 | 1 |
How the 92570 rate is calculated
Each of 92570’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 · 92570
RVUs × geographic indexes × conversion factor
Work0.55
0.55 RVUs× 1.000 GPCI
Practice expense0.38
0.38 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.9400
Conversion factor
$33.4009
Medicare rate
$31.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,841
- Code
- 92570
- Physician work
- 0.55
- Practice expense
- 0.38
- Malpractice
- 0.01
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.55 | × 1.000 | 0.5500 |
| Practice expense | 0.38 | × 1.011 | 0.3842 |
| Malpractice | 0.01 | × 0.985 | 0.0098 |
| Total RVUs | 0.9440 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$31.53
Office: (0.55 × 1 + 0.38 × 1.011 + 0.01 × 0.985) × $33.4009 = $31.53
Facility: (0.55 × 1 + 0.15 × 1.011 + 0.01 × 0.985) × $33.4009 = $23.76
Payment rules and modifiers for 92570
The CMS indicators that decide how 92570 is paid alongside other services.
CMS payment indicators · 92570
Immittance testing, tympanometry and reflex measures
| 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
92570 without CQ · national office
$31.40
Immittance testing, tympanometry and reflex measures
92570-CQ · Allowed amount unchanged
$31.40
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 92570 has changed in Puerto Rico
92570 · Office / nonfacility
$31.53
Effective 2026-10-01
The base rate is $0.40 higher than on 2025-10-01, moving from $31.13 to $31.53 (1.3%).
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
$31.13changed to$31.53
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.39 changed to 0.38
- Malpractice RVU 0.02 changed to 0.01
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$32.03changed to$31.13
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$31.51changed to$32.03
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$32.63changed to$31.51
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$32.53changed to$32.63
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$33.65changed to$32.53
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.38 changed to 0.39
- Malpractice RVU 0.04 changed to 0.02
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$33.93changed to$33.65
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$34.02changed to$33.93
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.36 changed to 0.38
- Malpractice RVU 0.03 changed to 0.04
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$33.23changed to$34.02
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.34 changed to 0.36
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$32.83changed to$33.23
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.33 changed to 0.34
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$30.57changed to$32.83
- Conversion factor 35.8887 changed to 35.9996
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$28.34changed to$30.57
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$28.33changed to$28.34
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.02 changed to 0.03
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$28.19changed to$28.33
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$28.17changed to$28.19
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.03 changed to 0.02
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$27.27changed to$28.17
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.36 changed to 0.33
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $27.27
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $31.53 | $23.76 | RVU26D |
| 2026-07-01 | $31.53 | $23.76 | RVU26C |
| 2026-04-01 | $31.53 | $23.76 | RVU26B |
| 2026-01-01 | $31.53 | $23.76 | RVU26A |
| 2025-10-01 | $31.13 | $27.87 | RVU25D |
| 2025-07-01 | $31.13 | $27.87 | RVU25C |
| 2025-04-01 | $31.13 | $27.87 | RVU25B |
| 2025-01-01 | $31.13 | $27.87 | RVU25A |
| 2024-10-01 | $32.03 | $28.68 | RVU24D |
| 2024-07-01 | $32.03 | $28.68 | RVU24C |
| 2024-04-01 | $32.03 | $28.68 | RVU24B |
| 2024-03-09 | $32.03 | $28.68 | RVU24AR |
| 2024-01-01 | $31.51 | $28.21 | RVU24A |
| 2023-10-01 | $32.63 | $29.21 | RVU23D |
| 2023-07-01 | $32.53 | $29.14 | RVU23C |
| 2023-04-01 | $32.53 | $29.14 | RVU23B |
| 2023-01-01 | $32.53 | $29.14 | RVU23A |
| 2022-10-01 | $33.65 | $30.17 | RVU22D |
| 2022-07-01 | $33.65 | $30.17 | RVU22C |
| 2022-04-01 | $33.65 | $30.17 | RVU22B |
| 2022-01-01 | $33.65 | $30.17 | RVU22A |
| 2021-10-01 | $33.93 | $30.42 | RVU21D |
| 2021-07-01 | $33.93 | $30.42 | RVU21C |
| 2021-04-01 | $33.93 | $30.42 | RVU21B |
| 2021-01-01 | $33.93 | $30.42 | RVU21A |
| 2020-10-01 | $34.02 | $30.74 | RVU20D |
| 2020-07-01 | $34.02 | $30.74 | RVU20C |
| 2020-04-01 | $34.02 | $30.74 | RVU20B |
| 2020-01-01 | $34.02 | $30.74 | RVU20A |
| 2019-10-01 | $33.23 | $30.69 | RVU19D |
| 2019-07-01 | $33.23 | $30.69 | RVU19C |
| 2019-04-01 | $33.23 | $30.69 | RVU19B |
| 2019-01-01 | $33.23 | $30.69 | RVU19A |
| 2018-10-01 | $32.83 | $30.66 | RVU18D |
| 2018-07-01 | $32.83 | $30.66 | RVU18C |
| 2018-04-01 | $32.83 | $30.66 | RVU18B |
| 2018-01-01 | $32.83 | $30.66 | RVU18AR1 |
| 2017-10-01 | $30.57 | $28.72 | RVU17D |
| 2017-07-01 | $30.57 | $28.72 | RVU17C |
| 2017-04-01 | $30.57 | $28.72 | RVU17B |
| 2017-01-01 | $30.57 | $28.72 | RVU17A |
| 2016-10-01 | $28.34 | $26.82 | RVU16D |
| 2016-07-01 | $28.34 | $26.82 | RVU16C |
| 2016-04-01 | $28.34 | $26.82 | RVU16B |
| 2016-01-01 | $28.34 | $26.82 | RVU16A |
| 2015-10-01 | $28.33 | $26.81 | RVU15D |
| 2015-07-01 | $28.33 | $26.81 | RVU15C |
| 2015-04-01 | $28.19 | $26.68 | RVU15B |
| 2015-01-01 | $28.19 | $26.68 | RVU15A |
| 2014-10-01 | $28.17 | $26.69 | RVU14D |
| 2014-07-01 | $28.17 | $26.69 | RVU14C |
| 2014-04-01 | $28.17 | $26.69 | RVU14B |
| 2014-01-01 | $28.17 | $26.69 | RVU14A |
| 2013-10-01 | $27.27 | $25.66 | RVU13D |
| 2013-07-01 | $27.27 | $25.66 | RVU13C |
| 2013-04-01 | $27.27 | $25.66 | RVU13B |
| 2013-01-01 | $27.27 | $25.66 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
92570 billing questions
When should 92570 be selected instead of 92567?
Use 92570 for the comprehensive immittance battery, including tympanometry and acoustic reflex measurements. Use 92567 when the service is tympanometry alone.
How does 92570 differ from 92550?
92570 represents the broader battery, including reflex decay testing. 92550 covers tympanometry with acoustic reflex threshold measurements.
Can the component measurements also be billed separately?
The measurements are included in the comprehensive service represented by 92570. Do not separately report a component test for work already included in the battery.
Should modifier 50 be appended for testing both ears?
No. CMS prices 92570 as bilateral, and modifier 50 does not increase payment.
Can modifier 26 be used for the interpretation?
No. CMS identifies this as a service for which the professional component modifier does not apply.
What documentation supports reporting 92570?
Document the clinical reason for testing and the tympanometry and acoustic reflex measurements performed, with the resulting 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
Show the CMS file lines behind this rate
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