Billing code 92540: Vestibular evaluationMedicare rate & RVUs
Reports a basic vestibular test battery assessing eye movements and positional responses during evaluation of dizziness, vertigo, or balance symptoms.
Medicare pays $103.54 for 92540 nationally in the office. Local office rates run $95.59–$132.51.
Medicare rate · 92540
Vestibular evaluation
Swap in your local Medicare rate.
- Work RVUs
- 1.46
- Total RVUs
- 3.10
- Global days
- XXX
National rate · 2026
$103.54
Office setting, before claim adjustments.
See every locality for 92540 → · Billed by an NP, PA or therapist? →
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 10 sections
What 92540 covers
This code represents a basic vestibular battery that evaluates eye movements and responses to changes in gaze, visual tracking, and head or body position. The included test elements are spontaneous nystagmus with gaze and fixation, positional nystagmus, oscillating tracking, and optokinetic nystagmus. Audiologists and otolaryngology or neurotology clinicians commonly perform or interpret these tests in outpatient settings when assessing dizziness, vertigo, or balance complaints.
Report 92540 when the documented service includes the basic battery, rather than when only an individual test is performed. The record should identify the tests conducted and support the clinician’s interpretation of the findings. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The listed modifiers are separately priced under the CMS facts for this code.
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 92540 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$95.59 to $132.51
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $96.49 | Unavailable |
| Alaska* | $131.14 | Unavailable |
| Arizona | $101.77 | Unavailable |
| Arkansas | $95.59 | Unavailable |
| Atlanta | $104.69 | Unavailable |
| Austin | $106.70 | Unavailable |
| Bakersfield | $109.40 | Unavailable |
| Baltimore/Surr. Cntys | $108.43 | Unavailable |
| Beaumont | $98.63 | Unavailable |
| Brazoria | $103.30 | Unavailable |
| Chicago | $105.02 | Unavailable |
| Chico | $109.26 | Unavailable |
| Colorado | $107.44 | Unavailable |
| Connecticut | $108.82 | Unavailable |
| Dallas | $103.67 | Unavailable |
| Dc + Md/Va Suburbs | $115.88 | Unavailable |
| Delaware | $103.07 | Unavailable |
| Detroit | $102.11 | Unavailable |
| East St. Louis | $99.89 | Unavailable |
| El Centro | $109.26 | Unavailable |
| Fort Lauderdale | $104.79 | Unavailable |
| Fort Worth | $103.14 | Unavailable |
| Fresno | $109.26 | Unavailable |
| Galveston | $103.44 | Unavailable |
| Hanford-Corcoran | $109.26 | Unavailable |
| Hawaii, Guam | $110.67 | Unavailable |
| Houston | $103.81 | Unavailable |
| Idaho | $98.86 | Unavailable |
| Indiana | $99.25 | Unavailable |
| Iowa | $98.54 | Unavailable |
| Kansas | $98.02 | Unavailable |
| Kentucky | $97.48 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $115.22 | Unavailable |
| Madera | $109.26 | Unavailable |
| Manhattan | $115.82 | Unavailable |
| Merced | $109.26 | Unavailable |
| Metropolitan Boston | $115.97 | Unavailable |
| Metropolitan Kansas City | $100.23 | Unavailable |
| Metropolitan Philadelphia | $106.77 | Unavailable |
| Metropolitan St. Louis | $100.95 | Unavailable |
| Miami | $106.78 | Unavailable |
| Minnesota | $104.64 | Unavailable |
| Mississippi | $95.85 | Unavailable |
| Modesto | $109.26 | Unavailable |
| Montana** | $103.54 | Unavailable |
| Napa | $123.49 | Unavailable |
| Nebraska | $98.96 | Unavailable |
| Nevada** | $103.49 | Unavailable |
| New Hampshire | $105.68 | Unavailable |
| New Mexico | $99.19 | Unavailable |
| New Orleans | $100.44 | Unavailable |
| North Carolina | $99.68 | Unavailable |
| North Dakota** | $103.15 | Unavailable |
| Northern Nj | $115.32 | Unavailable |
| Nyc Suburbs/Long Island | $117.46 | Unavailable |
| Ohio | $98.84 | Unavailable |
| Oklahoma | $97.60 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $114.50 | Unavailable |
| Portland | $110.16 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $111.02 | Unavailable |
| Puerto Rico | $104.13 | Unavailable |
| Queens | $116.81 | Unavailable |
| Redding | $109.26 | Unavailable |
| Rest Of California | $109.26 | Unavailable |
| Rest Of Florida | $101.50 | Unavailable |
| Rest Of Georgia | $97.83 | Unavailable |
| Rest Of Illinois | $99.21 | Unavailable |
| Rest Of Louisiana | $97.29 | Unavailable |
| Rest Of Maine | $98.96 | Unavailable |
| Rest Of Maryland | $104.62 | Unavailable |
| Rest Of Massachusetts | $107.06 | Unavailable |
| Rest Of Michigan | $98.92 | Unavailable |
| Rest Of Missouri | $96.06 | Unavailable |
| Rest Of New Jersey | $110.54 | Unavailable |
| Rest Of New York | $100.64 | Unavailable |
| Rest Of Oregon | $103.13 | Unavailable |
| Rest Of Pennsylvania | $99.07 | Unavailable |
| Rest Of Texas | $100.72 | Unavailable |
| Rest Of Washington | $106.88 | Unavailable |
| Rhode Island | $106.18 | Unavailable |
| Riverside-San Bernardino-Ontario | $109.52 | Unavailable |
| Sacramento-Roseville-Folsom | $113.81 | Unavailable |
| Salinas | $113.35 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $115.31 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $130.00 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $129.98 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $132.51 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $132.42 | Unavailable |
| San Luis Obispo-Paso Robles | $111.58 | Unavailable |
| Santa Cruz-Watsonville | $115.89 | Unavailable |
| Santa Maria-Santa Barbara | $113.58 | Unavailable |
| Santa Rosa-Petaluma | $117.03 | Unavailable |
| Seattle (King Cnty) | $118.14 | Unavailable |
| South Carolina | $99.33 | Unavailable |
| South Dakota** | $103.10 | Unavailable |
| Southern Maine | $102.81 | Unavailable |
| Stockton | $109.26 | Unavailable |
| Suburban Chicago | $105.86 | Unavailable |
| Tennessee | $98.31 | Unavailable |
| Utah | $100.23 | Unavailable |
| Vallejo | $123.46 | Unavailable |
| Vermont | $102.67 | Unavailable |
| Virgin Islands | $104.13 | Unavailable |
| Virginia | $102.43 | Unavailable |
| Visalia | $109.26 | Unavailable |
| West Virginia | $96.74 | Unavailable |
| Wisconsin | $100.81 | Unavailable |
| Wyoming** | $103.37 | Unavailable |
| Yuba City | $109.26 | Unavailable |
92540 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.
$95.59
$131.14
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 | $131.14 | 1 |
| AL | $96.49 | 1 |
| AR | $95.59 | 1 |
| AZ | $101.77 | 1 |
| CA | $109.26–$132.51 | 29 |
| CO | $107.44 | 1 |
| CT | $108.82 | 1 |
| DC | $115.88 | 1 |
| DE | $103.07 | 1 |
| FL | $101.50–$106.78 | 3 |
| GA | $97.83–$104.69 | 2 |
| GU | $110.67 | 1 |
| HI | $110.67 | 1 |
| IA | $98.54 | 1 |
| ID | $98.86 | 1 |
| IL | $99.21–$105.86 | 4 |
| IN | $99.25 | 1 |
| KS | $98.02 | 1 |
| KY | $97.48 | 1 |
| LA | $97.29–$100.44 | 2 |
| MA | $107.06–$115.97 | 2 |
| MD | $104.62–$115.88 | 3 |
| ME | $98.96–$102.81 | 2 |
| MI | $98.92–$102.11 | 2 |
| MN | $104.64 | 1 |
| MO | $96.06–$100.95 | 3 |
| MS | $95.85 | 1 |
| MT | $103.54 | 1 |
| NC | $99.68 | 1 |
| ND | $103.15 | 1 |
| NE | $98.96 | 1 |
| NH | $105.68 | 1 |
| NJ | $110.54–$115.32 | 2 |
| NM | $99.19 | 1 |
| NV | $103.49 | 1 |
| NY | $100.64–$117.46 | 5 |
| OH | $98.84 | 1 |
| OK | $97.60 | 1 |
| OR | $103.13–$110.16 | 2 |
| PA | $99.07–$106.77 | 2 |
| PR | $104.13 | 1 |
| RI | $106.18 | 1 |
| SC | $99.33 | 1 |
| SD | $103.10 | 1 |
| TN | $98.31 | 1 |
| TX | $98.63–$106.70 | 8 |
| UT | $100.23 | 1 |
| VA | $102.43–$115.88 | 2 |
| VI | $104.13 | 1 |
| VT | $102.67 | 1 |
| WA | $106.88–$118.14 | 2 |
| WI | $100.81 | 1 |
| WV | $96.74 | 1 |
| WY | $103.37 | 1 |
How the 92540 rate is calculated
Each of 92540’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 · 92540
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.46Practice expense 1.62Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92540
The CMS indicators that decide how 92540 is paid alongside other services.
CMS payment indicators · 92540
Vestibular 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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
92540 without 26 · national office
$103.54
Vestibular evaluation
92540-26 · Professional component
$74.48
Pays only the interpretation and report.
92540 compared with similar codes
Compare codes
92540 vs 92541 vs 92542 vs 92544 vs 92545: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 92541Nystagmus test
- 92541 is for spontaneous nystagmus testing alone; 92540 represents the broader battery that includes it along with three other test elements.
- 92542Positional nystagmus
- 92542 covers positional nystagmus testing alone. Choose 92540 when the documented service includes the basic battery.
- 92544Vestibular test
- 92544 is the standalone optokinetic nystagmus test; that test is one element of the broader 92540 battery.
- 92545Vestibular test
- 92545 reports oscillating tracking testing alone, while 92540 covers that test as part of the basic vestibular battery.
92540 billing questions
When should 92540 be chosen instead of 92541 or 92542?
Use 92540 for the basic battery, which includes spontaneous and positional nystagmus testing along with tracking and optokinetic testing. Use an individual test code when only that standalone test is performed.
Can the individual tests included in 92540 also be reported separately?
The basic battery includes spontaneous nystagmus, positional nystagmus, oscillating tracking, and optokinetic testing. Do not separately report those same included test elements as standalone services for the same evaluation.
What do modifiers 26 and TC identify for this code?
Modifier 26 reports the professional interpretation, while modifier TC reports the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting the basic battery?
Document which included test elements were performed and the findings and interpretation. A record describing only one component test supports consideration of its individual code instead.
Does 92540 include caloric testing?
No. Caloric vestibular testing is a separate test service; it is not one of the four elements in the basic battery.
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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