Billing code 92568: Acoustic reflexMedicare rate & RVUs in Utah

Reports measurement of the sound level that triggers an acoustic reflex, typically during diagnostic evaluation of hearing or middle-ear function.

CMS RVU26DEffective Oct 1, 20261 payment locality2.4K Medicare services in 2024

Medicare pays $15.01 for 92568 in the office in Utah (Utah). Which amount applies depends on the service address.

$15.01Office (non-facility)
$12.50Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 92568 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 92568 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 92568 covers

An audiologist typically uses immittance equipment to measure the sound level that elicits an involuntary middle-ear muscle response. The test may be included in an outpatient diagnostic hearing evaluation when reflex thresholds help interpret auditory or middle-ear findings. Results are recorded by ear and can be considered alongside tympanometry and audiometry.

Report 92568 for the reflex-threshold measurement itself, rather than tympanometry alone or a broader immittance service that includes this measurement. Documentation should identify the ears tested, test conditions, measured thresholds or absent responses, and relevant interpretation. CMS prices the service on a bilateral basis, so modifier 50 does not increase payment. CMS identifies this as a therapy service; the professional component modifier does not apply.

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.

92568 in Utah

92568 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$15.01$12.50

How the 92568 rate is calculated

Each of 92568’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 · 92568

RVUs × geographic indexes × conversion factor

Work0.29

0.29 RVUs× 1.000 GPCI

Practice expense0.16

0.16 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.4600

Conversion factor

$33.4009

Medicare rate

$15.36

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 92568

The CMS indicators that decide how 92568 is paid alongside other services.

CMS payment indicators · 92568

Acoustic reflex

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

92568 without CQ · national office

$15.36

Acoustic reflex

92568-CQ · Allowed amount unchanged

$15.36

Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.

92568 compared with similar codes

Compare codes · National

4 codes, side by side

  • 92568

    Acoustic reflex0.29 wRVU

    $15.36

  • 92567

    Tympanometry0.2 wRVU

    $16.03+$0.67

  • 92550

    Middle-ear testing0.35 wRVU

    $21.71+$6.35

  • 92570

    Immittance testing0.55 wRVU

    $31.40+$16.04

How to choose

92567Tympanometry
92567 reports tympanometry, which evaluates middle-ear pressure and mobility. Use 92568 for measuring the sound level that triggers an acoustic reflex.
92550Middle-ear testing
92550 combines tympanometry with reflex-threshold measurements. 92568 represents the reflex-threshold test rather than that combined service.
92570Immittance testing
92570 covers a broader acoustic immittance service that includes reflex thresholds. 92568 is specific to the threshold measurement.

92568 billing questions

How is 92568 different from tympanometry?

92568 measures the sound level that elicits an acoustic reflex. Tympanometry, reported with 92567, assesses middle-ear pressure and mobility.

Should 92568 be reported with 92550?

92550 represents tympanometry together with reflex-threshold measurements. When both services are performed as that combined service, compare 92550 with reporting the individual tests.

How does 92568 differ from 92570?

92570 describes a broader acoustic immittance service that includes reflex-threshold measurement. Use 92568 when reporting the threshold test itself, rather than the broader service.

Should modifier 50 be appended?

CMS prices 92568 as bilateral. Modifier 50 does not increase payment.

Can modifier 26 be used for the professional work?

No. CMS identifies this as a therapy service for which the professional component modifier does not apply.

What should the record include?

Document the ears tested, test conditions, measured thresholds or absent responses, and the interpretation of the findings.

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
RVUs for 92568PPRRVU2026_Oct_nonQPP.csv, line 11,840 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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