$36.40–$50.20
92538 is for recorded caloric testing on one side; 92537 is the bilateral recorded-test code.
On this page
CMS RVU26D · Effective 2026-10-01
92538 Caloric vestibular test Medicare reimbursement rates
Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction. Compare 92538 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92538?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$19.79–$27.49
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $7.70 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 92538 pays more and less
109 payment localities
$19.79 to $27.49
Vestibular testing
About 92538: Unilateral recorded caloric vestibular test
Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction.
This test stimulates the vestibular system by introducing warm or cool air or water into the ear canal, then records the resulting eye movements, including nystagmus. Audiologists and physicians such as otolaryngologists may perform or interpret it in an audiology, ENT, or balance-testing setting. It is used as part of a diagnostic evaluation when symptoms or findings suggest impaired vestibular function.
Choose 92538 when recorded caloric testing is performed on one side; 92537 is the bilateral recorded-test sibling. Documentation should identify the ear tested, the stimulation performed, the recorded response, and the interpretation when applicable. The global service includes the professional interpretation and the technical work, equipment, and staff. Modifier 26 reports the interpretation alone, while modifier TC reports the technical portion alone. CMS pricing treats this code as already priced bilaterally, so modifier 50 does not increase payment.
CMS billing rules for 92538
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.29 · 45%
- Practice expense (office) RVU0.34 · 52%
- Malpractice RVU0.02 · 3%
5.5K
Medicare services in 2024 · #1806 by national volume
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.
92538 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
92533
No office rateCaloric vestibular test
92533 is caloric vestibular testing without recording. Choose 92538 when the test includes recording.
$95.59–$132.51
92540 is a basic vestibular evaluation, not the specific recorded caloric stimulus and response reported with 92538.
92532
No office ratePositional nystagmus test
92532 evaluates positional nystagmus; 92538 records the vestibular response to caloric stimulation.
See how rates vary across the country
92538 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$19.79
$26.99
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $26.99 | 1 |
| AL | $20.00 | 1 |
| AR | $19.79 | 1 |
| AZ | $21.26 | 1 |
| CA | $22.66–$27.49 | 29 |
| CO | $22.41 | 1 |
| CT | $22.92 | 1 |
| DC | $24.33 | 1 |
| DE | $21.56 | 1 |
| FL | $21.55–$23.20 | 3 |
| GA | $20.61–$22.06 | 2 |
| GU | $22.99 | 1 |
| HI | $22.99 | 1 |
| IA | $20.34 | 1 |
| ID | $20.45 | 1 |
| IL | $21.10–$22.70 | 4 |
| IN | $20.54 | 1 |
| KS | $20.29 | 1 |
| KY | $20.39 | 1 |
| LA | $20.38–$21.13 | 2 |
| MA | $22.33–$24.24 | 2 |
| MD | $21.89–$24.33 | 3 |
| ME | $20.55–$21.36 | 2 |
| MI | $20.81–$21.77 | 2 |
| MN | $21.57 | 1 |
| MO | $20.13–$21.17 | 3 |
| MS | $19.96 | 1 |
| MT | $21.71 | 1 |
| NC | $20.71 | 1 |
| ND | $21.31 | 1 |
| NE | $20.42 | 1 |
| NH | $22.09 | 1 |
| NJ | $23.21–$24.18 | 2 |
| NM | $20.90 | 1 |
| NV | $21.61 | 1 |
| NY | $20.94–$25.05 | 5 |
| OH | $20.73 | 1 |
| OK | $20.35 | 1 |
| OR | $21.47–$22.96 | 2 |
| PA | $20.74–$22.48 | 2 |
| PR | $21.83 | 1 |
| RI | $22.20 | 1 |
| SC | $20.75 | 1 |
| SD | $21.27 | 1 |
| TN | $20.37 | 1 |
| TX | $20.64–$22.31 | 8 |
| UT | $20.96 | 1 |
| VA | $21.32–$24.33 | 2 |
| VI | $21.83 | 1 |
| VT | $21.27 | 1 |
| WA | $22.28–$24.65 | 2 |
| WI | $20.77 | 1 |
| WV | $20.51 | 1 |
| WY | $21.54 | 1 |
Compare 92538 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $20.00 | Facility Unavailable |
| Alaska* | Office $26.99 | Facility Unavailable |
| Arizona | Office $21.26 | Facility Unavailable |
| Arkansas | Office $19.79 | Facility Unavailable |
| Atlanta | Office $22.06 | Facility Unavailable |
| Austin | Office $22.31 | Facility Unavailable |
| Bakersfield | Office $22.72 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $22.85 | Facility Unavailable |
| Beaumont | Office $20.64 | Facility Unavailable |
| Brazoria | Office $21.54 | Facility Unavailable |
| Chicago | Office $22.70 | Facility Unavailable |
| Chico | Office $22.66 | Facility Unavailable |
| Colorado | Office $22.41 | Facility Unavailable |
| Connecticut | Office $22.92 | Facility Unavailable |
| Dallas | Office $21.66 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $24.33 | Facility Unavailable |
| Delaware | Office $21.56 | Facility Unavailable |
| Detroit | Office $21.77 | Facility Unavailable |
| East St. Louis | Office $21.48 | Facility Unavailable |
| El Centro | Office $22.66 | Facility Unavailable |
| Fort Lauderdale | Office $22.40 | Facility Unavailable |
| Fort Worth | Office $21.55 | Facility Unavailable |
| Fresno | Office $22.66 | Facility Unavailable |
| Galveston | Office $21.59 | Facility Unavailable |
| Hanford-Corcoran | Office $22.66 | Facility Unavailable |
| Hawaii, Guam | Office $22.99 | Facility Unavailable |
| Houston | Office $21.96 | Facility Unavailable |
| Idaho | Office $20.45 | Facility Unavailable |
| Indiana | Office $20.54 | Facility Unavailable |
| Iowa | Office $20.34 | Facility Unavailable |
| Kansas | Office $20.29 | Facility Unavailable |
| Kentucky | Office $20.39 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $23.96 | Facility Unavailable |
| Madera | Office $22.66 | Facility Unavailable |
| Manhattan | Office $24.56 | Facility Unavailable |
| Merced | Office $22.66 | Facility Unavailable |
| Metropolitan Boston | Office $24.24 | Facility Unavailable |
| Metropolitan Kansas City | Office $21.00 | Facility Unavailable |
| Metropolitan Philadelphia | Office $22.48 | Facility Unavailable |
| Metropolitan St. Louis | Office $21.17 | Facility Unavailable |
| Miami | Office $23.20 | Facility Unavailable |
| Minnesota | Office $21.57 | Facility Unavailable |
| Mississippi | Office $19.96 | Facility Unavailable |
| Modesto | Office $22.66 | Facility Unavailable |
| Montana** | Office $21.71 | Facility Unavailable |
| Napa | Office $25.60 | Facility Unavailable |
| Nebraska | Office $20.42 | Facility Unavailable |
| Nevada** | Office $21.61 | Facility Unavailable |
| New Hampshire | Office $22.09 | Facility Unavailable |
| New Mexico | Office $20.90 | Facility Unavailable |
| New Orleans | Office $21.13 | Facility Unavailable |
| North Carolina | Office $20.71 | Facility Unavailable |
| North Dakota** | Office $21.31 | Facility Unavailable |
| Northern Nj | Office $24.18 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $25.05 | Facility Unavailable |
| Ohio | Office $20.73 | Facility Unavailable |
| Oklahoma | Office $20.35 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $23.80 | Facility Unavailable |
| Portland | Office $22.96 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $23.37 | Facility Unavailable |
| Puerto Rico | Office $21.83 | Facility Unavailable |
| Queens | Office $24.69 | Facility Unavailable |
| Redding | Office $22.66 | Facility Unavailable |
| Rest Of California | Office $22.66 | Facility Unavailable |
| Rest Of Florida | Office $21.55 | Facility Unavailable |
| Rest Of Georgia | Office $20.61 | Facility Unavailable |
| Rest Of Illinois | Office $21.10 | Facility Unavailable |
| Rest Of Louisiana | Office $20.38 | Facility Unavailable |
| Rest Of Maine | Office $20.55 | Facility Unavailable |
| Rest Of Maryland | Office $21.89 | Facility Unavailable |
| Rest Of Massachusetts | Office $22.33 | Facility Unavailable |
| Rest Of Michigan | Office $20.81 | Facility Unavailable |
| Rest Of Missouri | Office $20.13 | Facility Unavailable |
| Rest Of New Jersey | Office $23.21 | Facility Unavailable |
| Rest Of New York | Office $20.94 | Facility Unavailable |
| Rest Of Oregon | Office $21.47 | Facility Unavailable |
| Rest Of Pennsylvania | Office $20.74 | Facility Unavailable |
| Rest Of Texas | Office $21.07 | Facility Unavailable |
| Rest Of Washington | Office $22.28 | Facility Unavailable |
| Rhode Island | Office $22.20 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $22.88 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $23.60 | Facility Unavailable |
| Salinas | Office $23.51 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $23.92 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $26.93 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $26.90 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $27.49 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $27.39 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $23.14 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $24.05 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $23.56 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $24.28 | Facility Unavailable |
| Seattle (King Cnty) | Office $24.65 | Facility Unavailable |
| South Carolina | Office $20.75 | Facility Unavailable |
| South Dakota** | Office $21.27 | Facility Unavailable |
| Southern Maine | Office $21.36 | Facility Unavailable |
| Stockton | Office $22.66 | Facility Unavailable |
| Suburban Chicago | Office $22.60 | Facility Unavailable |
| Tennessee | Office $20.37 | Facility Unavailable |
| Utah | Office $20.96 | Facility Unavailable |
| Vallejo | Office $25.57 | Facility Unavailable |
| Vermont | Office $21.27 | Facility Unavailable |
| Virgin Islands | Office $21.83 | Facility Unavailable |
| Virginia | Office $21.32 | Facility Unavailable |
| Visalia | Office $22.66 | Facility Unavailable |
| West Virginia | Office $20.51 | Facility Unavailable |
| Wisconsin | Office $20.77 | Facility Unavailable |
| Wyoming** | Office $21.54 | Facility Unavailable |
| Yuba City | Office $22.66 | Facility Unavailable |
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92538 billing questions
How does 92538 differ from 92537?
92538 is for recorded caloric testing on one side; 92537 is the bilateral recorded-test code. Document which ear was tested.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical portion. Without either modifier, the code represents the global service.
Should modifier 50 be added when both ears are tested?
No. CMS pricing treats 92538 as already priced bilaterally, and modifier 50 does not increase payment. Use the code that reflects the service performed and document the tested ear or ears.
What documentation supports 92538?
Record the ear tested, the caloric stimulation performed, the eye-movement response, and the interpretation. The record should support that the test included recording.
When is 92533 a better fit?
92533 describes caloric vestibular testing without recording. Use 92538 when the caloric test includes recording.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,79792537,,Caloric vstblr test w/rec,A,,0.59,0.57,,0.57,NA,0.02,1.18,1.18,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,79892537,26,Caloric vstblr test w/rec,A,,0.59,0.31,,0.31,,0.01,0.91,0.91,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,79992537,TC,Caloric vstblr test w/rec,A,,0.00,0.26,,0.26,NA,0.01,0.27,0.27,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,80092538,,Caloric vstblr test w/rec,A,,0.29,0.34,,0.34,NA,0.02,0.65,0.65,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,80192538,26,Caloric vstblr test w/rec,A,,0.29,0.16,,0.16,,0.01,0.46,0.46,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,80292538,TC,Caloric vstblr test w/rec,A,,0.00,0.18,,0.18,NA,0.01,0.19,0.19,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,80392540,,Basic vestibular evaluation,A,,1.46,1.62,,1.62,NA,0.02,3.10,3.10,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00