CPT code 92588: Otoacoustic emissions, comprehensive evaluation2026 Medicare rate & RVUs in Hawaii, Guam, HI
Reports a comprehensive, multi-frequency otoacoustic emission assessment with interpretation, commonly used to evaluate cochlear function when behavioral hearing testing is limited.
In Hawaii, Guam, HI, Medicare pays $35.47 for 92588 in the office.
Check a contract rate as a % of Medicare · 92588 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 92588 covers
An audiologist uses a small probe in the ear canal to present sounds and record the cochlea’s resulting otoacoustic emissions. This comprehensive assessment samples multiple frequencies and helps evaluate outer hair cell function, including when an infant or another patient cannot reliably complete behavioral testing. It provides objective information about cochlear responses, rather than behavioral hearing thresholds.
Report the comprehensive service when the evaluation meets the code’s frequency scope and includes interpretation and a report; retain the test results and interpretation in the record. A limited evoked otoacoustic emission evaluation is a different service. CMS separately prices the professional interpretation and the technical equipment-and-staff portions: report modifier 26 for the professional component or TC for the technical component, or report the global service without either modifier. CMS pricing treats the service as bilateral, so 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 Hawaii, Guam, HI compares for 92588
Across 109 of 109 payment localities, the office rate for 92588 runs from $31.34 in Arkansas to $43.58 in Alaska. Hawaii, Guam, HI pays $35.47. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Hawaii, Guam, HI · this page$35.47
- Los Angeles, CA · California$36.95+$1.48
- Washington, DC area · District of Columbia$37.42+$1.95
- Miami, FL · Florida$35.36−$0.11
- Chicago, IL · Illinois$34.80−$0.67
- Manhattan, NY · New York$37.68+$2.21
- Alaska · Alaska$43.58+$8.11
Other areas in Hawaii first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $31.61 | — |
| ArkansasArkansas | $31.34 | — |
| ArizonaArizona | $33.18 | — |
| Bakersfield, CACalifornia | $35.23 | — |
| Chico, CACalifornia | $35.15 | — |
| El Centro, CACalifornia | $35.15 | — |
| Fresno, CACalifornia | $35.15 | — |
| Hanford, CACalifornia | $35.15 | — |
| Madera, CACalifornia | $35.15 | — |
| Merced, CACalifornia | $35.15 | — |
| Modesto, CACalifornia | $35.15 | — |
| Napa, CACalifornia | $39.24 | — |
| Oxnard, CACalifornia | $36.67 | — |
| Redding, CACalifornia | $35.15 | — |
| Rest of CaliforniaCalifornia | $35.15 | — |
| Riverside, CACalifornia | $35.38 | — |
| Sacramento, CACalifornia | $36.48 | — |
| Salinas, CACalifornia | $36.33 | — |
| San Diego, CACalifornia | $36.86 | — |
| Marin County, CACalifornia | $41.14 | — |
| San Francisco, CACalifornia | $41.12 | — |
| San Benito County, CACalifornia | $41.94 | — |
| Santa Clara County, CACalifornia | $41.85 | — |
| San Luis Obispo, CACalifornia | $35.78 | — |
| Santa Cruz, CACalifornia | $36.97 | — |
| Santa Maria, CACalifornia | $36.38 | — |
| Santa Rosa, CACalifornia | $37.33 | — |
| Stockton, CACalifornia | $35.15 | — |
| Vallejo, CACalifornia | $39.20 | — |
| Visalia, CACalifornia | $35.15 | — |
| Yuba City, CACalifornia | $35.15 | — |
| ColoradoColorado | $34.75 | — |
| ConnecticutConnecticut | $35.37 | — |
| DelawareDelaware | $33.58 | — |
| Fort Lauderdale, FLFlorida | $34.47 | — |
| Rest of FloridaFlorida | $33.42 | — |
| Atlanta, GAGeorgia | $34.16 | — |
| Rest of GeorgiaGeorgia | $32.28 | — |
| IowaIowa | $32.08 | — |
| IdahoIdaho | $32.21 | — |
| East St. Louis, ILIllinois | $33.24 | — |
| Rest of IllinoisIllinois | $32.83 | — |
| Suburban Chicago, ILIllinois | $34.78 | — |
| IndianaIndiana | $32.32 | — |
| KansasKansas | $31.99 | — |
| KentuckyKentucky | $32.05 | — |
| New Orleans, LALouisiana | $32.96 | — |
| Rest of LouisianaLouisiana | $32.02 | — |
| Metropolitan Boston, MAMassachusetts | $37.27 | — |
| Rest of MassachusettsMassachusetts | $34.67 | — |
| Baltimore area, MDMaryland | $35.26 | — |
| Rest of MarylandMaryland | $34.04 | — |
| Rest of MaineMaine | $32.31 | — |
| Southern Maine, MEMaine | $33.36 | — |
| Detroit, MIMichigan | $33.68 | — |
| Rest of MichiganMichigan | $32.54 | — |
| MinnesotaMinnesota | $33.69 | — |
| Metropolitan Kansas City, MOMissouri | $32.82 | — |
| Metropolitan St. Louis, MOMissouri | $33.03 | — |
| Rest of MissouriMissouri | $31.69 | — |
| MississippiMississippi | $31.52 | — |
| MontanaMontana | $33.73 | — |
| North CarolinaNorth Carolina | $32.51 | — |
| North DakotaNorth Dakota | $33.34 | — |
| NebraskaNebraska | $32.19 | — |
| New HampshireNew Hampshire | $34.25 | — |
| Northern New JerseyNew Jersey | $37.29 | — |
| Rest of New JerseyNew Jersey | $35.89 | — |
| New MexicoNew Mexico | $32.65 | — |
| NevadaNevada | $33.64 | — |
| NYC suburbs and Long Island, NYNew York | $38.26 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $36.10 | — |
| Queens, NYNew York | $37.88 | — |
| Rest of New YorkNew York | $32.80 | — |
| OhioOhio | $32.46 | — |
| OklahomaOklahoma | $32.01 | — |
| Portland, OROregon | $35.49 | — |
| Rest of OregonOregon | $33.48 | — |
| Metropolitan Philadelphia, PAPennsylvania | $34.80 | — |
| Rest of PennsylvaniaPennsylvania | $32.49 | — |
| Puerto RicoPuerto Rico | $33.89 | — |
| Rhode IslandRhode Island | $34.50 | — |
| South CarolinaSouth Carolina | $32.52 | — |
| South DakotaSouth Dakota | $33.29 | — |
| TennesseeTennessee | $32.09 | — |
| Austin, TXTexas | $34.55 | — |
| Beaumont, TXTexas | $32.36 | — |
| Brazoria, TXTexas | $33.60 | — |
| Dallas, TXTexas | $33.75 | — |
| Fort Worth, TXTexas | $33.61 | — |
| Galveston, TXTexas | $33.66 | — |
| Houston, TXTexas | $34.03 | — |
| Rest of TexasTexas | $32.92 | — |
| UtahUtah | $32.78 | — |
| VirginiaVirginia | $33.29 | — |
| Virgin Islands, VIUnited States Virgin Islands | $33.89 | — |
| VermontVermont | $33.26 | — |
| Rest of WashingtonWashington | $34.59 | — |
| King County, WAWashington | $37.87 | — |
| WisconsinWisconsin | $32.66 | — |
| West VirginiaWest Virginia | $32.10 | — |
| WyomingWyoming | $33.56 | — |
92588 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.
$31.34
$43.58
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 | $43.58 | 1 |
| AL | $31.61 | 1 |
| AR | $31.34 | 1 |
| AZ | $33.18 | 1 |
| CA | $35.15–$41.94 | 29 |
| CO | $34.75 | 1 |
| CT | $35.37 | 1 |
| DC | $37.42 | 1 |
| DE | $33.58 | 1 |
| FL | $33.42–$35.36 | 3 |
| GA | $32.28–$34.16 | 2 |
| GU | $35.47 | 1 |
| HI | $35.47 | 1 |
| IA | $32.08 | 1 |
| ID | $32.21 | 1 |
| IL | $32.83–$34.80 | 4 |
| IN | $32.32 | 1 |
| KS | $31.99 | 1 |
| KY | $32.05 | 1 |
| LA | $32.02–$32.96 | 2 |
| MA | $34.67–$37.27 | 2 |
| MD | $34.04–$37.42 | 3 |
| ME | $32.31–$33.36 | 2 |
| MI | $32.54–$33.68 | 2 |
| MN | $33.69 | 1 |
| MO | $31.69–$33.03 | 3 |
| MS | $31.52 | 1 |
| MT | $33.73 | 1 |
| NC | $32.51 | 1 |
| ND | $33.34 | 1 |
| NE | $32.19 | 1 |
| NH | $34.25 | 1 |
| NJ | $35.89–$37.29 | 2 |
| NM | $32.65 | 1 |
| NV | $33.64 | 1 |
| NY | $32.80–$38.26 | 5 |
| OH | $32.46 | 1 |
| OK | $32.01 | 1 |
| OR | $33.48–$35.49 | 2 |
| PA | $32.49–$34.80 | 2 |
| PR | $33.89 | 1 |
| RI | $34.50 | 1 |
| SC | $32.52 | 1 |
| SD | $33.29 | 1 |
| TN | $32.09 | 1 |
| TX | $32.36–$34.55 | 8 |
| UT | $32.78 | 1 |
| VA | $33.29–$37.42 | 2 |
| VI | $33.89 | 1 |
| VT | $33.26 | 1 |
| WA | $34.59–$37.87 | 2 |
| WI | $32.66 | 1 |
| WV | $32.10 | 1 |
| WY | $33.56 | 1 |
How the 92588 rate is calculated
Each of 92588’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 · 92588
RVUs × geographic indexes × conversion factor
Work0.55
0.55 RVUs× 1.000 GPCI
Practice expense0.44
0.44 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.0100
Conversion factor
$33.4009
Medicare rate
$33.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Hawaii, Guam, HI inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,854
- Code
- 92588
- Physician work
- 0.55
- Practice expense
- 0.44
- Malpractice
- 0.02
GPCI2026.csv
46
- Locality
- Hawaii, Guam, HI
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.55 | × 1.000 | 0.5500 |
| Practice expense | 0.44 | × 1.137 | 0.5003 |
| Malpractice | 0.02 | × 0.579 | 0.0116 |
| Total RVUs | 1.0619 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Hawaii, Guam, HI$35.47
Office: (0.55 × 1 + 0.44 × 1.137 + 0.02 × 0.579) × $33.4009 = $35.47
Payment rules and modifiers for 92588
The CMS indicators that decide how 92588 is paid alongside other services.
CMS payment indicators · 92588
Otoacoustic emissions, comprehensive evaluation
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
92588 without 26 · national office
$33.73
Otoacoustic emissions, comprehensive evaluation
92588-26 · Professional component
$28.72
Pays only the interpretation and report.
How 92588 has changed in Hawaii, Guam, HI
92588 · Office / nonfacility
$35.47
Effective 2026-10-01
The base rate is $1.34 higher than on 2025-10-01, moving from $34.13 to $35.47 (3.9%).
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
$34.13changed to$35.47
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.43 changed to 0.44
- Practice expense GPCI 1.149 changed to 1.137
- Malpractice GPCI 0.561 changed to 0.579
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$34.75changed to$34.13
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.42 changed to 0.43
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$34.18changed to$34.75
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$36.20changed to$34.18
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.44 changed to 0.42
- Work GPCI 1.003 changed to 1.000
- Practice expense GPCI 1.146 changed to 1.149
- Malpractice GPCI 0.618 changed to 0.561
January 1, 2023
RVU23A
$36.70changed to$36.20
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.43 changed to 0.44
- Work GPCI 1.010 changed to 1.003
- Practice expense GPCI 1.143 changed to 1.146
- Malpractice GPCI 0.675 changed to 0.618
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$36.60changed to$36.70
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.42 changed to 0.43
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$36.53changed to$36.60
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.39 changed to 0.42
- Work GPCI 1.006 changed to 1.010
- Practice expense GPCI 1.144 changed to 1.143
- Malpractice GPCI 0.644 changed to 0.675
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$35.57changed to$36.53
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.37 changed to 0.39
- Work GPCI 1.001 changed to 1.006
- Practice expense GPCI 1.146 changed to 1.144
- Malpractice GPCI 0.614 changed to 0.644
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$35.11changed to$35.57
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.36 changed to 0.37
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$35.35changed to$35.11
- Conversion factor 35.8887 changed to 35.9996
- Malpractice RVU 0.03 changed to 0.02
- Work GPCI 1.002 changed to 1.001
- Practice expense GPCI 1.154 changed to 1.146
- Malpractice GPCI 0.616 changed to 0.614
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$35.17changed to$35.35
- Conversion factor 35.8043 changed to 35.8887
- Malpractice RVU 0.02 changed to 0.03
- Work GPCI 1.003 changed to 1.002
- Practice expense GPCI 1.162 changed to 1.154
- Malpractice GPCI 0.618 changed to 0.616
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$35.30changed to$35.17
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$35.12changed to$35.30
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$35.38changed to$35.12
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.03 changed to 0.02
- Work GPCI 1.002 changed to 1.003
- Practice expense GPCI 1.158 changed to 1.162
- Malpractice GPCI 0.659 changed to 0.618
Held through RVU15B.
January 1, 2014
RVU14A
$34.74changed to$35.38
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.39 changed to 0.36
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 1.154 changed to 1.158
- Malpractice GPCI 0.700 changed to 0.659
Held through RVU14B, RVU14C, RVU14D.
October 1, 2013
RVU13D
No ratechanged to$34.74
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $35.47 | Not available in this setting | RVU26D |
| 2026-07-01 | $35.47 | Not available in this setting | RVU26C |
| 2026-04-01 | $35.47 | Not available in this setting | RVU26B |
| 2026-01-01 | $35.47 | Not available in this setting | RVU26A |
| 2025-10-01 | $34.13 | Not available in this setting | RVU25D |
| 2025-07-01 | $34.13 | Not available in this setting | RVU25C |
| 2025-04-01 | $34.13 | Not available in this setting | RVU25B |
| 2025-01-01 | $34.13 | Not available in this setting | RVU25A |
| 2024-10-01 | $34.75 | Not available in this setting | RVU24D |
| 2024-07-01 | $34.75 | Not available in this setting | RVU24C |
| 2024-04-01 | $34.75 | Not available in this setting | RVU24B |
| 2024-03-09 | $34.75 | Not available in this setting | RVU24AR |
| 2024-01-01 | $34.18 | Not available in this setting | RVU24A |
| 2023-10-01 | $36.20 | Not available in this setting | RVU23D |
| 2023-07-01 | $36.20 | Not available in this setting | RVU23C |
| 2023-04-01 | $36.20 | Not available in this setting | RVU23B |
| 2023-01-01 | $36.20 | Not available in this setting | RVU23A |
| 2022-10-01 | $36.70 | Not available in this setting | RVU22D |
| 2022-07-01 | $36.70 | Not available in this setting | RVU22C |
| 2022-04-01 | $36.70 | Not available in this setting | RVU22B |
| 2022-01-01 | $36.70 | Not available in this setting | RVU22A |
| 2021-10-01 | $36.60 | Not available in this setting | RVU21D |
| 2021-07-01 | $36.60 | Not available in this setting | RVU21C |
| 2021-04-01 | $36.60 | Not available in this setting | RVU21B |
| 2021-01-01 | $36.60 | Not available in this setting | RVU21A |
| 2020-10-01 | $36.53 | Not available in this setting | RVU20D |
| 2020-07-01 | $36.53 | Not available in this setting | RVU20C |
| 2020-04-01 | $36.53 | Not available in this setting | RVU20B |
| 2020-01-01 | $36.53 | Not available in this setting | RVU20A |
| 2019-10-01 | $35.57 | Not available in this setting | RVU19D |
| 2019-07-01 | $35.57 | Not available in this setting | RVU19C |
| 2019-04-01 | $35.57 | Not available in this setting | RVU19B |
| 2019-01-01 | $35.57 | Not available in this setting | RVU19A |
| 2018-10-01 | $35.11 | Not available in this setting | RVU18D |
| 2018-07-01 | $35.11 | Not available in this setting | RVU18C |
| 2018-04-01 | $35.11 | Not available in this setting | RVU18B |
| 2018-01-01 | $35.11 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $35.35 | Not available in this setting | RVU17D |
| 2017-07-01 | $35.35 | Not available in this setting | RVU17C |
| 2017-04-01 | $35.35 | Not available in this setting | RVU17B |
| 2017-01-01 | $35.35 | Not available in this setting | RVU17A |
| 2016-10-01 | $35.17 | Not available in this setting | RVU16D |
| 2016-07-01 | $35.17 | Not available in this setting | RVU16C |
| 2016-04-01 | $35.17 | Not available in this setting | RVU16B |
| 2016-01-01 | $35.17 | Not available in this setting | RVU16A |
| 2015-10-01 | $35.30 | Not available in this setting | RVU15D |
| 2015-07-01 | $35.30 | Not available in this setting | RVU15C |
| 2015-04-01 | $35.12 | Not available in this setting | RVU15B |
| 2015-01-01 | $35.12 | Not available in this setting | RVU15A |
| 2014-10-01 | $35.38 | Not available in this setting | RVU14D |
| 2014-07-01 | $35.38 | Not available in this setting | RVU14C |
| 2014-04-01 | $35.38 | Not available in this setting | RVU14B |
| 2014-01-01 | $35.38 | Not available in this setting | RVU14A |
| 2013-10-01 | $34.74 | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Hawaii, Guam, HI rate applies
Hawaii, Guam, HI is a Medicare payment area, not a city. Our Census mapping connects it to 163 cities and communities in Hawaii. Some span more than one payment area; confirm with the service ZIP.
- Ahuimanu
- Aiea
- Ainaloa
- Anahola
- Black Sands
- Captain Cook
- Discovery Harbour
- East Honolulu
92588 billing questions
How does this differ from 92587?
92588 is for a comprehensive evaluation covering at least 12 frequencies, with interpretation and a report. 92587 is the limited evaluation, generally covering 3–6 frequencies.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion involving equipment and staff. Without either modifier, the claim represents the global service.
Should modifier 50 be reported?
No. CMS pricing already treats 92588 as bilateral, and modifier 50 does not increase payment.
What documentation supports the comprehensive service?
Keep the frequency-specific test results, evidence that the comprehensive frequency scope was performed, and the interpretation and report. The record should make clear that the service was more than a limited evaluation.
Is this the same as a behavioral hearing test?
No. Otoacoustic emission testing records cochlear responses to sound; behavioral audiometry measures responses from the patient and can establish hearing thresholds. The tests answer different clinical questions.
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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