No office rate
92504 is a diagnostic microscopic examination of the ear. 92502 is an otolaryngologic examination performed under general anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
92504 Ear microscopy Medicare reimbursement rates in Tennessee
Reports a binocular-microscope examination of the ear canal and eardrum when magnified inspection provides a distinct diagnostic assessment beyond routine otoscopy. Compare 92504 office and facility rates across CMS payment localities in Tennessee.
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 92504 in Tennessee?
Tennessee 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
$26.53
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
$7.41
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
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.
Otolaryngology
About 92504: Binocular microscopic ear examination
Reports a binocular-microscope examination of the ear canal and eardrum when magnified inspection provides a distinct diagnostic assessment beyond routine otoscopy.
An otolaryngologist typically uses a binocular microscope to inspect the external ear canal and tympanic membrane in an office or other clinical setting. Magnification can help assess findings such as canal inflammation, debris, a suspected perforation, or the position of a tympanostomy tube. The service is a diagnostic examination, not simply the use of a microscope as a visual aid during another procedure.
Select this code when the clinician performs and documents a distinct microscopic ear assessment. Record the ear or ears examined, the relevant findings, and how the examination informs the clinical assessment or plan. Routine otoscopy alone does not support this service, and microscope use solely to perform cerumen removal or another procedure should not be treated as a separate diagnostic examination. CMS physician fee schedule valuation accounts for work, practice expense, and malpractice inputs, with practice expense values differing between office and facility settings.
Where the value comes from
- Work RVU0.18 · 21%
- Practice expense (office) RVU0.67 · 78%
- Malpractice RVU0.01 · 1%
257.8K
Medicare services in 2024 · #337 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.
92504 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$44.34
Use 69210 for removal of impacted cerumen with instrumentation. Use 92504 for a distinct diagnostic microscopic examination, not merely visualization during removal.
$15.36
69209 describes impacted cerumen removal by irrigation or lavage. 92504 describes microscopic examination, not wax removal.
Compare 92504 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
Tennessee →
Office / nonfacility
$26.53
Facility
$7.41
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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 92504 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
11,778
- Code
- 92504
- Physician work
- 0.18
- Practice expense
- 0.67
- Malpractice
- 0.01
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.18 | × 1.000 | 0.1800 |
| Practice expense | 0.67 | × 0.909 | 0.6090 |
| Malpractice | 0.01 | × 0.537 | 0.0054 |
| Total RVUs | 0.7944 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$26.53
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.18 | 1 |
| Practice expense | 0.67 | 0.909 |
| Malpractice | 0.01 | 0.537 |
(0.18 × 1 + 0.67 × 0.909 + 0.01 × 0.537) × $33.4009 = $26.53
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.18 | 1 |
| Practice expense | 0.04 | 0.909 |
| Malpractice | 0.01 | 0.537 |
(0.18 × 1 + 0.04 × 0.909 + 0.01 × 0.537) × $33.4009 = $7.41
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.
92504 billing questions
When is microscopic examination distinct from routine otoscopy?
Report 92504 when the clinician performs a diagnostic examination using binocular magnification and documents the findings. A routine look with an otoscope during an E/M visit is not the same service.
Can 92504 be reported with an office E/M service?
It may be reported with an E/M service when both are performed and the record supports a distinct microscopic examination as well as the separately documented E/M work.
Should 92504 be used when impacted cerumen is removed?
Choose the cerumen-removal code when removal is the service performed. Do not report 92504 merely because the microscope helps visualize that removal.
How does 92504 differ from 92502?
92504 describes diagnostic microscopic examination of the ear. 92502 is for an otolaryngologic examination performed under general anesthesia.
What documentation supports 92504?
Document use of binocular microscopy, the ear findings, and the diagnostic purpose of the examination. Identify the side or sides examined in the note.
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.
11,77592499,26,Unlisted oph svc/procedure,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77692499,TC,Unlisted oph svc/procedure,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77792502,,Ear and throat examination,A,,1.47,1.01,NA,1.01,,0.11,2.59,2.59,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77892504,,Ear microscopy examination,A,,0.18,0.67,,0.04,,0.01,0.86,0.23,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,77992507,,Tx sp lang voice comm indiv,A,,1.30,0.97,,0.97,NA,0.01,2.28,2.28,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,78092508,,Tx sp lang voice comm group,A,,0.33,0.38,,0.38,NA,0.01,0.72,0.72,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,78192511,,Nasopharyngoscopy,A,,0.59,2.84,,0.35,,0.04,3.47,0.98,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780