How much does Medicare pay for CPT 92526?

Medicare allowed an average of $84.14 per service and paid $66.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $168.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92526?

Treatment of swallowing and feeding disorder. It was billed 201,599 times to 21,371 Medicare beneficiaries by 865 providers in 2024.

Does 92526 pay differently in an office than a hospital?

Yes. The allowed amount averaged $84.14 in an office setting and $88.94 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 92526 most?

Speech Language Pathologist, with 198,885 services from 817 clinicians. Next are Otolaryngology, Pulmonary Disease, Physical Medicine and Rehabilitation.

CPT 92526

Treatment of swallowing and feeding disorder

$84.14Medicare-allowed amount per service, averaged across 201,599 services

Providers submitted

$168.47

Asking price, not received

Medicare allowed

$84.14

The fee schedule figure

Medicare paid

$66.27

Balance is patient coinsurance

Providers submitted an average of $168.47 for this code and Medicare allowed $84.14 — 2.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $66.27 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $84.14
Hospital / facility: $88.94

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 201,538 services were billed in an office setting and 61 in a facility.

Services: 201,599
Beneficiaries: 21,371
Providers billing it: 865
Total allowed: $16,962,540

What Medicare pays for CPT 92526

Across 201,599 services billed by 865 providers to 21,371 beneficiaries, Medicare allowed an average of $84.14 per service. That is 9.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 92526

Specialty	Services	Beneficiaries	Avg allowed	Providers
Speech Language Pathologist	198,885	20,018	$84.15	817
Otolaryngology	1,437	515	$85.17	24
Pulmonary Disease	565	460	$82.04	12
Physical Medicine and Rehabilitation	165	31	$79.56	1
Unknown Supplier/Provider Specialty	152	53	$79.58	1
Diagnostic Radiology	129	129	$74.33	2
Internal Medicine	109	85	$85.72	2
Neurology	88	39	$89.71	3
Physical Therapist in Private Practice	39	11	$76.19	1
Occupational Therapist in Private Practice	30	30	$86.42	2

92526 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	31,669	$92.06	$64.37	107
New Jersey	19,904	$88.47	$64.63	78
Florida	19,574	$81.93	$64.57	71
Pennsylvania	18,072	$83.22	$64.76	60
Texas	9,898	$82.65	$65.56	31
South Carolina	9,777	$78.67	$64.70	39
Virginia	8,929	$83.50	$64.60	37
Maryland	7,293	$87.38	$64.93	34
Ohio	5,553	$78.65	$64.92	23
Illinois	5,329	$81.31	$64.76	30
California	5,021	$88.56	$63.39	43
Georgia	4,834	$79.64	$64.53	22
Missouri	4,381	$79.59	$64.27	20
Tennessee	3,881	$78.05	$64.69	21
Wisconsin	3,445	$79.06	$63.87	15
Louisiana	3,221	$78.36	$65.24	9
Washington	3,091	$80.16	$61.99	17
Massachusetts	2,673	$87.18	$64.98	9
Delaware	2,631	$83.98	$64.18	8
Minnesota	2,546	$83.09	$63.72	19
Arkansas	2,342	$77.39	$64.65	6
Colorado	2,218	$84.29	$64.42	17
North Carolina	1,990	$79.62	$64.65	10
Nevada	1,859	$82.05	$64.64	7
Nebraska	1,845	$78.28	$64.59	9
Iowa	1,680	$79.17	$64.46	12
Kansas	1,555	$78.40	$64.03	9
Indiana	1,549	$78.62	$65.11	11
Oklahoma	1,529	$78.28	$65.52	9
New Hampshire	1,316	$84.04	$65.28	4
Maine	1,262	$80.81	$64.05	5
Mississippi	1,261	$76.49	$65.21	3
Arizona	1,081	$82.08	$64.22	12
Connecticut	939	$83.07	$61.66	8
Hawaii	923	$86.42	$64.02	3
Michigan	848	$80.34	$64.78	4
West Virginia	824	$78.92	$65.22	1
Alabama	695	$76.23	$64.10	7
Utah	655	$79.71	$65.70	9
New Mexico	634	$100.08	$65.24	3
Rhode Island	584	$83.43	$63.14	3
Oregon	485	$83.14	$64.17	4
Kentucky	336	$77.91	$64.07	2
Wyoming	318	$81.57	$62.57	3
District of Columbia	287	$89.19	$64.87	3
South Dakota	277	$79.51	$63.30	2
Alaska	277	$106.02	$63.30	2
Idaho	149	$73.26	$61.56	1
Montana	146	$81.53	$65.42	2
North Dakota	13	$78.19	$52.56	1

Related codes

92557Comprehensive hearing and speech recognition test$36.00
92567Test to assess middle ear function$15.98
92507Treatment of speech$72.06
92504Exam of ear using a microscope$26.45
92550Test for eardrum and muscle function$22.10
92588Placement of ear probe for computerized measurement of repeated sounds$33.35
92552Test for hearing various pitches$37.66
92540Evaluation and testing for balance$103.83
92556Test for ability to detect and repeat spoken words$43.60
92537Test to assess balance during warm and cool irrigation in both ears$38.90
92546Test for abnormal eye movement$131.13
92587Placement of ear probe for computerized measurement of sound$21.99

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.