Billing code 92557: Comprehensive hearing testMedicare rate & RVUs in Washington
Diagnostic hearing evaluation combining air and bone conduction thresholds with speech reception and word recognition testing, reported as one bilateral service.
Medicare pays $36.73–$40.17 for 92557 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 92557 covers
This diagnostic audiogram measures pure tone air and bone conduction thresholds across test frequencies, with masking when needed. It also measures a speech reception threshold and word recognition at levels above that threshold. Audiologists typically perform the testing in a sound booth at an ENT practice, hospital outpatient audiology department, or audiology clinic. Common indications include suspected hearing loss, tinnitus, asymmetric hearing loss, sudden hearing loss, and monitoring for ototoxic effects.
Report one unit when the pure tone and complete speech portions are performed for both ears. The record should show the air and bone thresholds, speech reception thresholds, word recognition scores, any masking used, and interpretation. Do not separately report 92553 or 92556 for testing included in 92557. CMS identifies this as a therapy service for which the professional component modifier does not apply, so modifier 26 is not used to bill an interpretation alone. CMS prices the service as bilateral; modifier 50 does not increase payment. If testing is limited to one ear, report the reduced service with modifier 52.
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 92557 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $36.73 | $26.18 |
| Seattle (King Cnty) | $40.17 | $27.87 |
How the 92557 rate is calculated
Each of 92557’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 · 92557
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.60Practice expense 0.46Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 92557
The CMS indicators that decide how 92557 is paid alongside other services.
CMS payment indicators · 92557
Comprehensive hearing test
| 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 | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
92557 without CQ · national office
$35.74
Comprehensive hearing test
92557-CQ · Allowed amount unchanged
$35.74
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.
92557 compared with similar codes
Compare codes
92557 vs 92553 vs 92556 vs 92551 vs 92550: national Medicare rates
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How to choose
- 92553Audiometry
- Choose 92553 when air and bone thresholds are obtained without complete speech audiometry. When speech reception threshold and word recognition are also tested, report 92557 instead of separate 92553 and 92556.
- 92556Speech audiometry
- 92556 covers speech reception threshold and word recognition without pure tone thresholds. When air and bone thresholds are also obtained, report 92557 instead of the separate component codes.
- 92551Pure tone hearing test air
- 92551 screens hearing using air conduction pure tones. 92557 obtains diagnostic air and bone thresholds together with speech reception and word recognition results.
- 92550Middle-ear testing
- 92550 assesses middle ear function with tympanometry and acoustic reflex thresholds, rather than measuring hearing thresholds. It may be reported alongside 92557 when both services are performed.
92557 billing questions
Can 92553 or 92556 be billed with 92557 for the same testing?
No. 92557 combines air and bone pure tone audiometry with complete speech audiometry. Reporting either component code for those same tests would duplicate the service.
Should modifier 50 or RT/LT be added when both ears are tested?
No. One unit of 92557 represents bilateral testing, and CMS states that modifier 50 does not increase payment.
What if only one ear could be tested?
Append modifier 52 to indicate that the bilateral service was reduced to testing one ear. Document which ear was tested and why the other ear was not.
Is tympanometry included?
No. Tympanometry is separate; depending on the immittance measures performed, 92550, 92567, or 92570 may be reported at the same visit.
Can modifier 26 be used when a physician interprets an audiogram performed elsewhere?
No. CMS identifies 92557 as a therapy service for which the professional component modifier does not apply; an interpretation alone is not billed as 92557-26.
What if speech testing is not completed?
If only air and bone thresholds are obtained, report 92553 instead. Complete speech audiometry, including speech reception threshold and word recognition, is needed for 92557.
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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