Billing code 92541: Nystagmus testMedicare rate & RVUs in Guam
Reports recorded assessment of spontaneous and gaze-related nystagmus during vestibular testing, often used to evaluate patients with dizziness or balance symptoms.
Medicare pays $25.95 for 92541 in the office in Guam (Hawaii, Guam). 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 92541 covers
This vestibular test records involuntary eye movements that occur spontaneously and during gaze assessment. Audiologists, otolaryngologists, and other clinicians performing vestibular evaluations may use electronystagmography or videonystagmography equipment in an audiology clinic, ENT practice, or vestibular laboratory. Results can help characterize eye-movement findings in patients evaluated for dizziness, vertigo, or imbalance.
Report 92541 for the recorded spontaneous nystagmus assessment, including gaze; documentation should identify the test performed and its recorded findings. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for interpretation, modifier TC for the technical service, or neither modifier for the global service. The recorded assessment differs from a basic vestibular evaluation code that represents a defined combination of tests.
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.
92541 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $25.95 | Unavailable |
How the 92541 rate is calculated
Each of 92541’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 · 92541
RVUs × geographic indexes × conversion factor
Work0.39
0.39 RVUs× 1.000 GPCI
Practice expense0.33
0.33 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.7400
Conversion factor
$33.4009
Medicare rate
$24.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 92541
The CMS indicators that decide how 92541 is paid alongside other services.
CMS payment indicators · 92541
Nystagmus test
| 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
92541 without 26 · national office
$24.72
Nystagmus test
92541-26 · Professional component
$20.37
Pays only the interpretation and report.
92541 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 92531Spontaneous nystagmus study
- Both address spontaneous nystagmus, but 92541 is the recorded assessment. Choose 92531 when the corresponding study is performed without recording.
- 92542Positional nystagmus
- 92542 evaluates nystagmus associated with changes in position and includes a minimum of four positions. 92541 assesses spontaneous nystagmus, including gaze.
- 92540Vestibular evaluation
- 92540 represents a basic vestibular evaluation comprising several specified tests. 92541 identifies the recorded spontaneous nystagmus assessment alone.
92541 billing questions
How does 92541 differ from 92531?
92541 describes the spontaneous and gaze assessment with recording. The 92531 code is the nearby option for the corresponding study without recording.
When should 92540 be considered instead?
92540 represents a basic vestibular evaluation that includes spontaneous nystagmus, positional nystagmus, optokinetic nystagmus, and oscillating tracking tests. Use 92541 for the individual recorded spontaneous nystagmus assessment.
Which modifier identifies interpretation?
Append modifier 26 when billing only the professional interpretation. Modifier TC identifies the technical service, and billing without either modifier represents the global service.
What should the record support?
Document that spontaneous and gaze-related eye movements were assessed and recorded, along with the findings and the interpretation when the professional component is billed.
Is this the positional nystagmus test?
No. 92541 addresses spontaneous nystagmus, including gaze assessment; 92542 is the recorded positional nystagmus test.
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
Fee sheets
Put 92541 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →