Billing code 92557: Comprehensive hearing testMedicare rate & RVUs

Diagnostic hearing evaluation combining air and bone conduction thresholds with speech reception and word recognition testing, reported as one bilateral service.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3M Medicare services in 2024

Medicare pays $35.74 for 92557 nationally in the office and $25.72 in a hospital or facility. Local office rates run $33.41–$46.61.

Medicare rate · 92557

Comprehensive hearing test

Work RVUs
0.6
Total RVUs
1.07
Global days
XXX

National rate · 2026

$35.74

Office setting, before claim adjustments.

See every locality for 92557 →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
  1. Medicare rate
  2. What 92557 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 92557 covers

This diagnostic audiogram measures pure tone air and bone conduction thresholds across test frequencies, with masking when needed. It also measures a speech reception threshold and word recognition at levels above that threshold. Audiologists typically perform the testing in a sound booth at an ENT practice, hospital outpatient audiology department, or audiology clinic. Common indications include suspected hearing loss, tinnitus, asymmetric hearing loss, sudden hearing loss, and monitoring for ototoxic effects.

Report one unit when the pure tone and complete speech portions are performed for both ears. The record should show the air and bone thresholds, speech reception thresholds, word recognition scores, any masking used, and interpretation. Do not separately report 92553 or 92556 for testing included in 92557. CMS identifies this as a therapy service for which the professional component modifier does not apply, so modifier 26 is not used to bill an interpretation alone. CMS prices the service as bilateral; modifier 50 does not increase payment. If testing is limited to one ear, report the reduced service with modifier 52.

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 92557 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

$33.41 to $46.61

$33.41$40.01$46.61
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

92557 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$33.67$24.91
Alaska*$46.61$35.94
Arizona$35.21$25.50
Arkansas$33.41$24.80
Atlanta$36.11$25.93
Austin$36.63$26.03
Bakersfield$37.46$26.48
Baltimore/Surr. Cntys$37.26$26.51
Beaumont$34.33$25.21
Brazoria$35.69$25.76

92557 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.

$33.41

$46.61

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
92557 office rate range by state
State / territoryOffice rate rangeLocalities
AK$46.611
AL$33.671
AR$33.411
AZ$35.211
CA$37.40–$44.5829
CO$36.891
CT$37.391
DC$39.591
DE$35.621
FL$35.23–$36.883
GA$34.14–$36.112
GU$37.701
HI$37.701
IA$34.231
ID$34.331
IL$34.59–$36.554
IN$34.451
KS$34.101
KY$34.011
LA$33.96–$34.882
MA$36.81–$39.502
MD$36.10–$39.593
ME$34.38–$35.482
MI$34.45–$35.432
MN$35.951
MO$33.61–$35.003
MS$33.521
MT$35.741
NC$34.591
ND$35.541
NE$34.351
NH$36.331
NJ$37.99–$39.482
NM$34.531
NV$35.701
NY$34.87–$40.215
OH$34.401
OK$34.021
OR$35.58–$37.682
PA$34.46–$36.792
PR$35.901
RI$36.591
SC$34.521
SD$35.521
TN$34.191
TX$34.33–$36.638
UT$34.781
VA$35.38–$39.592
VI$35.901
VT$35.421
WA$36.73–$40.172
WI$34.861
WV$33.871
WY$35.651

How the 92557 rate is calculated

Each of 92557’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 · 92557

RVUs × geographic indexes × conversion factor

Work0.60

0.60 RVUs× 1.000 GPCI

Practice expense0.46

0.46 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

1.0700

Conversion factor

$33.4009

Medicare rate

$35.74

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 92557

The CMS indicators that decide how 92557 is paid alongside other services.

CMS payment indicators · 92557

Comprehensive hearing test

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

92557 without CQ · national office

$35.74

Comprehensive hearing test

92557-CQ · Allowed amount unchanged

$35.74

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.

92557 compared with similar codes

Compare codes · National

5 codes, side by side

  • 92557

    Comprehensive hearing test0.6 wRVU

    $35.74

  • 92553

    Audiometry0 wRVU

    $49.10+$13.36

  • 92556

    Speech audiometry0 wRVU

    $46.43+$10.69

  • 92551

    Not on the physician fee schedule0 wRVU

    Not priced

  • 92550

    Middle-ear testing0.35 wRVU

    $21.71−$14.03

How to choose

92553Audiometry
Choose 92553 when air and bone thresholds are obtained without complete speech audiometry. When speech reception threshold and word recognition are also tested, report 92557 instead of separate 92553 and 92556.
92556Speech audiometry
92556 covers speech reception threshold and word recognition without pure tone thresholds. When air and bone thresholds are also obtained, report 92557 instead of the separate component codes.
92551Pure tone hearing test air
92551 screens hearing using air conduction pure tones. 92557 obtains diagnostic air and bone thresholds together with speech reception and word recognition results.
92550Middle-ear testing
92550 assesses middle ear function with tympanometry and acoustic reflex thresholds, rather than measuring hearing thresholds. It may be reported alongside 92557 when both services are performed.

92557 billing questions

Can 92553 or 92556 be billed with 92557 for the same testing?

No. 92557 combines air and bone pure tone audiometry with complete speech audiometry. Reporting either component code for those same tests would duplicate the service.

Should modifier 50 or RT/LT be added when both ears are tested?

No. One unit of 92557 represents bilateral testing, and CMS states that modifier 50 does not increase payment.

What if only one ear could be tested?

Append modifier 52 to indicate that the bilateral service was reduced to testing one ear. Document which ear was tested and why the other ear was not.

Is tympanometry included?

No. Tympanometry is separate; depending on the immittance measures performed, 92550, 92567, or 92570 may be reported at the same visit.

Can modifier 26 be used when a physician interprets an audiogram performed elsewhere?

No. CMS identifies 92557 as a therapy service for which the professional component modifier does not apply; an interpretation alone is not billed as 92557-26.

What if speech testing is not completed?

If only air and bone thresholds are obtained, report 92553 instead. Complete speech audiometry, including speech reception threshold and word recognition, is needed for 92557.

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
RVUs for 92557PPRRVU2026_Oct_nonQPP.csv, line 11,834 (RVU26D)

Open CMS sourceHow we calculate rates

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