Billing code 92584: ElectrocochleographyMedicare rate & RVUs in Guam
Electrocochleography records sound-evoked electrical responses from the cochlea and auditory nerve, often during evaluation of suspected endolymphatic hydrops.
Medicare pays $114.58 for 92584 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 92584 covers
Electrocochleography records electrical responses generated by the cochlea and auditory nerve after sound stimulation. An audiologist or otolaryngologist may perform it in an audiology clinic or hospital setting, commonly as part of evaluating suspected endolymphatic hydrops in a patient with symptoms such as episodic vertigo and fluctuating hearing. Electrodes may be placed in the ear canal or against the tympanic membrane, depending on the technique used.
Report 92584 for the electrocochleographic study, rather than for routine air- and bone-conduction audiometry, tympanometry, or otoacoustic emissions testing. Documentation should identify the clinical indication, ears tested, method or electrode placement, recorded responses, and interpretation. The CMS fee schedule prices this code as bilateral, so modifier 50 does not increase payment. When other audiologic tests are performed during the same encounter, document each test separately.
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.
92584 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $114.58 | Unavailable |
How the 92584 rate is calculated
Each of 92584’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 · 92584
RVUs × geographic indexes × conversion factor
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Work 0.98Practice expense 2.14Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92584
The CMS indicators that decide how 92584 is paid alongside other services.
CMS payment indicators · 92584
Electrocochleography
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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 | 0 | Physician service: no professional/technical split. |
92584 compared with similar codes
Compare codes
92584 vs 92557 vs 92587 vs 92588: national Medicare rates
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How to choose
- 92557Comprehensive hearing test
- 92557 assesses air- and bone-conduction thresholds and speech recognition. Choose 92584 when the performed test records sound-evoked cochlear and auditory nerve potentials.
- 92587Otoacoustic emissions
- 92587 is limited otoacoustic-emission testing, assessing cochlear outer hair cell responses. It is not electrocochleography.
- 92588Otoacoustic emissions
- 92588 is comprehensive otoacoustic-emission testing. It evaluates emissions rather than the electrical potentials recorded in electrocochleography.
92584 billing questions
When is 92584 appropriate instead of a standard hearing test?
Use 92584 for recording sound-evoked cochlear and auditory nerve potentials, such as during evaluation for suspected endolymphatic hydrops. Pure-tone or speech audiometry measures hearing thresholds or speech recognition instead.
Should modifier 50 be appended when both ears are tested?
No. CMS prices 92584 as a bilateral service, and modifier 50 does not increase payment.
Can audiometry or tympanometry be reported at the same visit?
They may be reported when those tests are separately performed and documented. The record should distinguish their results from the electrocochleographic responses.
How does 92584 differ from evoked auditory testing?
Electrocochleography records electrical potentials from the cochlea and auditory nerve. Evoked auditory testing codes such as 92587 and 92588 describe otoacoustic-emission testing, which evaluates cochlear outer hair cell responses.
What documentation supports reporting 92584?
Document the indication, ears tested, electrode method or placement, responses obtained, and clinical interpretation. The findings should support that electrocochleography—not only routine audiometry—was performed.
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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