How much does Medicare pay for CPT 92540?

Medicare allowed an average of $103.83 per service and paid $79.86 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $298.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92540?

Evaluation and testing for balance with recording. It was billed 64,986 times to 59,401 Medicare beneficiaries by 1,385 providers in 2024.

Does 92540 pay differently in an office than a hospital?

Yes. The allowed amount averaged $105.11 in an office setting and $76.42 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 92540 most?

Audiologist, with 23,915 services from 730 clinicians. Next are Neurology, Otolaryngology, Diagnostic Radiology.

CPT 92540

Evaluation and testing for balance with recording

$103.83Medicare-allowed amount per service, averaged across 64,986 services

Providers submitted

$298.22

Asking price, not received

Medicare allowed

$103.83

The fee schedule figure

Medicare paid

$79.86

Balance is patient coinsurance

Providers submitted an average of $298.22 for this code and Medicare allowed $103.83 — 2.9× 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 $79.86 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $105.11
Hospital / facility: $76.42

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 62,091 services were billed in an office setting and 2,895 in a facility.

Services: 64,986
Beneficiaries: 59,401
Providers billing it: 1,385
Total allowed: $6,747,496

What Medicare pays for CPT 92540

Across 64,986 services billed by 1,385 providers to 59,401 beneficiaries, Medicare allowed an average of $103.83 per service. 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 92540

Specialty	Services	Beneficiaries	Avg allowed	Providers
Audiologist	23,915	23,780	$101.04	730
Neurology	15,017	14,388	$106.03	194
Otolaryngology	11,552	11,495	$100.77	344
Diagnostic Radiology	5,011	2,463	$118.96	3
Internal Medicine	2,632	2,421	$110.87	45
General Practice	2,387	652	$108.47	3
Independent Diagnostic Testing Facility (IDTF)	1,731	1,718	$78.66	10
Family Practice	660	591	$110.49	19
Cardiology	521	509	$117.43	6
Nurse Practitioner	403	319	$94.11	9
Physician Assistant	249	236	$92.30	6
Physical Medicine and Rehabilitation	232	223	$104.59	6
Undefined Physician type	215	160	$102.25	1
Critical Care (Intensivists)	116	113	$126.71	1
Neurosurgery	112	112	$106.14	2

92540 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	13,993	$111.64	$76.86	148
Florida	7,879	$104.19	$81.10	210
California	7,583	$111.41	$79.26	77
Maryland	3,564	$109.54	$77.21	53
Arizona	3,313	$89.17	$71.09	54
Texas	3,254	$100.17	$79.38	96
New Jersey	2,115	$112.85	$79.75	48
Nevada	1,461	$99.13	$81.17	21
Kansas	1,270	$93.02	$74.70	18
Illinois	1,269	$104.57	$77.75	30
Georgia	1,206	$98.33	$76.75	34
Michigan	1,144	$97.92	$74.74	49
Alabama	1,068	$95.83	$79.94	32
Virginia	1,046	$104.87	$79.22	29
North Carolina	1,040	$97.20	$75.40	35
Missouri	1,035	$95.63	$76.39	19
Louisiana	1,033	$95.22	$76.03	35
Pennsylvania	1,023	$94.99	$72.83	38
Indiana	959	$98.61	$79.51	22
Tennessee	913	$95.37	$77.68	26
Massachusetts	861	$91.09	$64.31	14
Ohio	704	$91.20	$72.03	32
Washington	653	$102.96	$73.00	26
Utah	647	$101.04	$81.08	22
South Carolina	614	$99.19	$79.53	27
Colorado	579	$105.54	$79.49	22
Oklahoma	504	$97.56	$79.02	11
Mississippi	440	$92.97	$78.80	15
Connecticut	418	$113.88	$78.44	13
West Virginia	313	$98.13	$76.53	8
Minnesota	301	$91.29	$71.22	8
Oregon	284	$89.13	$65.88	9
Idaho	250	$88.06	$70.18	10
Nebraska	248	$96.92	$77.38	13
Kentucky	240	$97.58	$78.72	12
Delaware	237	$104.26	$80.49	9
Montana	219	$100.35	$74.75	9
South Dakota	195	$78.22	$57.43	6
New Mexico	180	$95.91	$73.51	6
Arkansas	164	$84.78	$72.78	7
Iowa	159	$99.83	$78.05	4
Hawaii	146	$107.38	$80.13	6
New Hampshire	145	$92.08	$68.07	6
Wisconsin	145	$67.59	$54.71	6
Puerto Rico	69	$105.50	$79.78	5
Wyoming	42	$104.69	$81.96	2
District of Columbia	24	$94.53	$76.92	1
Maine	19	$108.34	$74.68	1
Vermont	18	$98.76	$83.52	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
92526Treatment of swallowing and feeding disorder$84.14
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
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.