Billing code 92516: Facial nerve testMedicare rate & RVUs in Oregon
A focused assessment of facial nerve motor function, reported when evaluating facial weakness, paralysis, or a suspected nerve injury.
Medicare pays $74.61–$81.79 for 92516 in the office in Oregon, from Rest Of Oregon to Portland. 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 92516 covers
This service evaluates facial nerve motor function, including the patient’s ability to move facial muscles and the symmetry of those movements. It is used in cases such as new facial weakness or paralysis, including suspected Bell palsy or facial nerve injury. Otolaryngologists and other clinicians evaluating facial nerve disorders may perform it in an office or facility setting. The findings can help characterize the deficit and guide further evaluation or treatment.
Report 92516 for a distinct facial nerve function assessment, not merely a brief facial inspection during a general visit. The record should identify the reason for testing, the facial movements or responses assessed, and the findings, including affected side and degree or pattern of weakness when documented. If needle electromyography is performed to assess cranial nerve-supplied muscles, distinguish that service from this functional assessment and report the applicable electrodiagnostic code. CMS payment facts supplied for this code do not specify additional payment-rule details.
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 92516 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $81.79 | $19.08 |
| Rest Of Oregon | $74.61 | $18.39 |
How the 92516 rate is calculated
Each of 92516’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 · 92516
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.42Practice expense 1.80Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92516
92516 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 92516
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$75.15
The facility rate would be $18.70 (+$56.45). In a facility, the facility bills its own costs separately.
92516 compared with similar codes
Compare codes
92516 vs 95867 vs 95868 vs 92517: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95867Needle EMG
- Use 95867 for needle EMG of cranial nerve-supplied muscles on one side. Use 92516 for the facial nerve function assessment rather than the needle EMG itself.
- 95868Needle EMG
- Use 95868 for needle EMG of cranial nerve-supplied muscles on both sides. It is an electrodiagnostic service, not the facial nerve function assessment represented by 92516.
- 92517VEMP testing
- 92517 evaluates cervical vestibular evoked myogenic responses. It assesses vestibular function, whereas 92516 evaluates facial nerve motor function.
92516 billing questions
When is 92516 more appropriate than an ordinary examination?
Use it for a distinct assessment of facial nerve motor function, such as evaluating facial weakness or paralysis. A brief observation of facial symmetry within a general examination alone does not describe that service.
Is 92516 the same as facial muscle needle EMG?
No. Needle EMG records electrical activity in selected muscles; 92516 represents a facial nerve function assessment. If both are performed, the documentation should distinguish the services.
What findings should the record include?
Document the clinical reason for testing, the movements or responses assessed, and the findings. Record the affected side and any observed asymmetry or weakness.
Can an ear examination be reported on the same date?
A separate otomicroscopic ear examination may be reported when it is performed and documented as a distinct service. The facial nerve assessment alone does not establish that an ear examination occurred.
Should the claim identify which side is affected?
Document the side and relevant findings in the clinical record. The supplied CMS facts do not specify a laterality modifier for this code.
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
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