$40.34
92538 is for recorded caloric testing on one side; 92537 is the bilateral recorded-test code.
On this page
CMS RVU26D · Effective 2026-10-01
92538 Caloric vestibular test Medicare reimbursement rates in Rhode Island
Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction. Compare 92538 office and facility rates across CMS payment localities in Rhode Island.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 92538 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$22.20
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vestibular testing
About 92538: Unilateral recorded caloric vestibular test
Reports recorded caloric stimulation of one ear to assess vestibular function, commonly during evaluation of dizziness, vertigo, or suspected peripheral vestibular dysfunction.
This test stimulates the vestibular system by introducing warm or cool air or water into the ear canal, then records the resulting eye movements, including nystagmus. Audiologists and physicians such as otolaryngologists may perform or interpret it in an audiology, ENT, or balance-testing setting. It is used as part of a diagnostic evaluation when symptoms or findings suggest impaired vestibular function.
Choose 92538 when recorded caloric testing is performed on one side; 92537 is the bilateral recorded-test sibling. Documentation should identify the ear tested, the stimulation performed, the recorded response, and the interpretation when applicable. The global service includes the professional interpretation and the technical work, equipment, and staff. Modifier 26 reports the interpretation alone, while modifier TC reports the technical portion alone. CMS pricing treats this code as already priced bilaterally, so modifier 50 does not increase payment.
CMS billing rules for 92538
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.29 · 45%
- Practice expense (office) RVU0.34 · 52%
- Malpractice RVU0.02 · 3%
5.5K
Medicare services in 2024 · #1806 by national volume
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.
92538 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
92533
No office rateCaloric vestibular test
92533 is caloric vestibular testing without recording. Choose 92538 when the test includes recording.
$106.18
92540 is a basic vestibular evaluation, not the specific recorded caloric stimulus and response reported with 92538.
92532
No office ratePositional nystagmus test
92532 evaluates positional nystagmus; 92538 records the vestibular response to caloric stimulation.
Compare 92538 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$22.20
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 92538 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
11,800
- Code
- 92538
- Physician work
- 0.29
- Practice expense
- 0.34
- Malpractice
- 0.02
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.29 | × 1.019 | 0.2955 |
| Practice expense | 0.34 | × 1.033 | 0.3512 |
| Malpractice | 0.02 | × 0.892 | 0.0178 |
| Total RVUs | 0.6646 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$22.20
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.29 | 1.019 |
| Practice expense | 0.34 | 1.033 |
| Malpractice | 0.02 | 0.892 |
(0.29 × 1.019 + 0.34 × 1.033 + 0.02 × 0.892) × $33.4009 = $22.20
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
92538 billing questions
How does 92538 differ from 92537?
92538 is for recorded caloric testing on one side; 92537 is the bilateral recorded-test code. Document which ear was tested.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical portion. Without either modifier, the code represents the global service.
Should modifier 50 be added when both ears are tested?
No. CMS pricing treats 92538 as already priced bilaterally, and modifier 50 does not increase payment. Use the code that reflects the service performed and document the tested ear or ears.
What documentation supports 92538?
Record the ear tested, the caloric stimulation performed, the eye-movement response, and the interpretation. The record should support that the test included recording.
When is 92533 a better fit?
92533 describes caloric vestibular testing without recording. Use 92538 when the caloric test includes recording.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,79792537,,Caloric vstblr test w/rec,A,,0.59,0.57,,0.57,NA,0.02,1.18,1.18,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,79892537,26,Caloric vstblr test w/rec,A,,0.59,0.31,,0.31,,0.01,0.91,0.91,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,79992537,TC,Caloric vstblr test w/rec,A,,0.00,0.26,,0.26,NA,0.01,0.27,0.27,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,80092538,,Caloric vstblr test w/rec,A,,0.29,0.34,,0.34,NA,0.02,0.65,0.65,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,80192538,26,Caloric vstblr test w/rec,A,,0.29,0.16,,0.16,,0.01,0.46,0.46,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,80292538,TC,Caloric vstblr test w/rec,A,,0.00,0.18,,0.18,NA,0.01,0.19,0.19,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,80392540,,Basic vestibular evaluation,A,,1.46,1.62,,1.62,NA,0.02,3.10,3.10,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537