Billing code 92542: Positional nystagmusMedicare rate & RVUs in Florida
Reports recorded observation of involuntary eye movements during positional maneuvers, helping evaluate dizziness and suspected vestibular disorders such as benign paroxysmal positional vertigo.
Medicare pays $28.20–$29.91 for 92542 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 92542 covers
For this test, the clinician changes the patient’s head or body position and observes and records resulting nystagmus, or involuntary rhythmic eye movement. It is commonly performed by an audiologist or an ear, nose, and throat specialist as part of an evaluation for dizziness, vertigo, or suspected positional vestibular dysfunction. The recorded findings help characterize whether eye movements are triggered by position and support the broader clinical assessment; this test alone does not establish a diagnosis such as benign paroxysmal positional vertigo.
Report 92542 when positional testing is performed with recording. The record should identify the maneuvers or positions tested, document the observed eye movements and relevant findings, and support the interpretation. The related unrecorded test is 92532. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or neither modifier for the global service. When the positional test is included in the broader basic vestibular evaluation reported with 92540, do not separately report it as an additional service.
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 92542 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$28.20 to $29.91
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $29.09 | Unavailable |
| Miami | $29.91 | Unavailable |
| Rest Of Florida | $28.20 | Unavailable |
How the 92542 rate is calculated
Each of 92542’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 · 92542
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.47Practice expense 0.36Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92542
The CMS indicators that decide how 92542 is paid alongside other services.
CMS payment indicators · 92542
Positional nystagmus
| 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
92542 without 26 · national office
$28.39
Positional nystagmus
92542-26 · Professional component
$24.38
Pays only the interpretation and report.
92542 compared with similar codes
Compare codes
92542 vs 92532 vs 92541 vs 92540: national Medicare rates
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How to choose
- 92532Positional nystagmus test
- Use 92542 for positional nystagmus testing with recording; use 92532 when the test is performed without recording.
- 92541Nystagmus test
- 92541 evaluates spontaneous nystagmus, rather than eye movements elicited by changing the patient’s position.
- 92540Vestibular evaluation
- 92540 represents a broader basic vestibular evaluation that includes positional nystagmus testing. Do not separately report 92542 for that included service.
92542 billing questions
How does 92542 differ from 92532?
Both describe positional nystagmus testing, but 92542 is the recorded service and 92532 is the unrecorded service. The documentation should support which version was performed.
Can 92542 be billed with 92540?
The basic vestibular evaluation reported with 92540 includes positional nystagmus testing. Do not separately report 92542 for that included test.
What do modifiers 26 and TC represent?
Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 92542?
Document the positional maneuvers performed, the recorded eye movements and findings, and the interpretation. The record should support that positional testing was performed with recording.
Can spontaneous nystagmus testing also be reported?
92541 describes spontaneous nystagmus testing, a different test from position-provoked nystagmus. It may be reported for a separately performed service when supported by the record and not included in a broader evaluation.
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
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