Billing code 92563: Tone decay testMedicare rate & RVUs

An audiologist uses a sustained pure tone to assess auditory adaptation, reporting this diagnostic test when evaluating a patient’s hearing response over time.

CMS RVU26DEffective Oct 1, 2026109 payment localities7.1K Medicare services in 2024

Medicare pays $35.74 for 92563 nationally in the office. Local office rates run $30.58–$51.23.

Medicare rate · 92563

Tone decay test

Swap in your local Medicare rate.

Work RVUs
0
Total RVUs
1.07
Global days
XXX

National rate · 2026

$35.74

Office setting, before claim adjustments.

See every locality for 92563 → · 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 92563 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 92563 covers

An audiologist presents a steady pure tone near the patient’s hearing threshold and assesses whether the patient continues to hear it. If the tone fades from perception, the examiner adjusts its intensity and documents the response. The test is used in diagnostic audiology, often in an office or an otolaryngology practice, as part of an evaluation of hearing function and auditory adaptation. It is distinct from routine threshold testing, which measures the softest sounds a patient can detect.

Report 92563 for the tone decay testing itself. The record should identify the test performed and document the patient’s responses and findings. CMS classifies this as a technical-component-only service; a separate code covers interpretation. The code is priced as bilateral, so modifier 50 does not increase payment. Its CMS work RVU is zero, reflecting that the service’s payment is assigned to its technical component rather than professional interpretation.

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 92563 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

$30.58 to $51.23

$30.58$40.91$51.23
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

92563 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$31.17Unavailable
Alaska*$37.89Unavailable
Arizona$34.59Unavailable
Arkansas$30.58Unavailable
Atlanta$36.37Unavailable
Austin$37.75Unavailable
Bakersfield$39.01Unavailable
Baltimore/Surr. Cntys$38.40Unavailable
Beaumont$32.53Unavailable
Brazoria$35.35Unavailable

92563 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.

$30.58

$45.11

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

View every state and territory as a table
92563 office rate range by state
State / territoryOffice rate rangeLocalities
AK$37.891
AL$31.171
AR$30.581
AZ$34.591
CA$38.98–$51.2329
CO$37.931
CT$38.541
DC$42.081
DE$35.281
FL$34.35–$37.703
GA$31.98–$36.372
GU$40.451
HI$40.451
IA$32.531
ID$32.731
IL$32.85–$36.954
IN$32.981
KS$32.171
KY$31.781
LA$31.65–$33.702
MA$37.55–$42.572
MD$36.14–$42.083
ME$32.78–$35.302
MI$32.70–$34.732
MN$36.531
MO$30.84–$34.043
MS$30.731
MT$35.741
NC$33.251
ND$35.541
NE$32.811
NH$37.151
NJ$39.03–$41.432
NM$32.871
NV$35.721
NY$33.87–$42.725
OH$32.661
OK$31.881
OR$35.50–$39.582
PA$32.82–$37.262
PR$36.121
RI$36.871
SC$33.001
SD$35.521
TN$32.361
TX$32.53–$37.758
UT$33.581
VA$35.04–$42.082
VI$36.121
VT$35.221
WA$37.54–$43.712
WI$34.021
WV$31.241
WY$35.651

How the 92563 rate is calculated

Each of 92563’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 · 92563

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 1.06Malpractice 0.01

1.0700 adjusted RVUs×$33.4009 conversion factor=$35.74

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 92563

The CMS indicators that decide how 92563 is paid alongside other services.

CMS payment indicators · 92563

Tone decay 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/technical3Technical component only.

92563 compared with similar codes

Compare codes

92563 vs 92552 vs 92553 vs 92562: national Medicare rates

Swap in your local Medicare rate.

  • 92563
    Tone decay test · 0 wRVU
    $35.74
  • 92552
    Pure-tone audiometry · 0 wRVU
    $40.42+$4.68
  • 92553
    Audiometry · 0 wRVU
    $49.10+$13.36
  • 92562
    Loudness balance · 0 wRVU
    $49.10+$13.36

How to choose

92552Pure-tone audiometry
Use 92552 for pure-tone air-conduction threshold measurement. Use 92563 when the service assesses response to a sustained tone over time.
92553Audiometry
92553 measures air- and bone-conduction hearing thresholds; 92563 assesses auditory adaptation to a sustained tone.
92562Loudness balance
92562 evaluates loudness balance between ears or within an ear. 92563 evaluates whether a sustained tone remains audible.

92563 billing questions

How is this different from pure-tone audiometry?

Pure-tone audiometry establishes hearing thresholds. Tone decay testing assesses whether a sustained tone remains audible and how the patient responds if it fades.

Does 92563 include interpretation?

No. CMS classifies 92563 as technical-component-only, and a separate code covers interpretation.

Should modifier 50 be added for testing both ears?

The code is already priced as bilateral. Modifier 50 does not increase payment.

What documentation supports reporting 92563?

Document the tone decay test, the patient’s responses during testing, and the resulting findings. Keep interpretation distinct from the technical testing service.

Can tone decay testing be reported with other audiometry?

It may be part of a broader diagnostic hearing evaluation that also includes threshold testing. Document each service performed and report the applicable code for each.

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 92563PPRRVU2026_Oct_nonQPP.csv, line 11,837 (RVU26D)

Open CMS sourceHow we calculate rates

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