How much does Medicare pay for CPT 92542?

Medicare allowed an average of $27.49 per service and paid $20.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $117.40, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92542?

Test for abnormal eye movement using 3 positions with recording. It was billed 11,624 times to 8,560 Medicare beneficiaries by 209 providers in 2024.

Does 92542 pay differently in an office than a hospital?

Yes. The allowed amount averaged $27.83 in an office setting and $23.99 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 92542 most?

Audiologist, with 6,031 services from 120 clinicians. Next are Otolaryngology, Neurology, Occupational Therapist in Private Practice.

CPT 92542

Test for abnormal eye movement using 3 positions with recording

$27.49Medicare-allowed amount per service, averaged across 11,624 services

Providers submitted

$117.40

Asking price, not received

Medicare allowed

$27.49

The fee schedule figure

Medicare paid

$20.78

Balance is patient coinsurance

Providers submitted an average of $117.40 for this code and Medicare allowed $27.49 — 4.3× 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 $20.78 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $27.83
Hospital / facility: $23.99

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. 10,596 services were billed in an office setting and 1,028 in a facility.

Services: 11,624
Beneficiaries: 8,560
Providers billing it: 209
Total allowed: $319,544

What Medicare pays for CPT 92542

Across 11,624 services billed by 209 providers to 8,560 beneficiaries, Medicare allowed an average of $27.49 per service. That is 1.4 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 92542

Specialty	Services	Beneficiaries	Avg allowed	Providers
Audiologist	6,031	4,343	$26.83	120
Otolaryngology	2,451	2,066	$27.40	58
Neurology	1,632	1,222	$30.10	8
Occupational Therapist in Private Practice	802	347	$28.08	2
Internal Medicine	278	270	$29.47	6
Physical Therapist in Private Practice	177	79	$26.64	5
Physician Assistant	120	111	$23.02	4
Nurse Practitioner	71	67	$22.19	4
Physical Medicine and Rehabilitation	35	33	$26.21	1
Ophthalmology	27	22	$30.12	1

92542 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
California	2,252	$30.10	$22.14	13
Florida	1,205	$28.46	$20.98	20
Georgia	896	$27.63	$20.73	5
Kansas	768	$26.43	$21.40	6
South Carolina	554	$24.84	$19.48	5
Texas	498	$22.47	$18.29	17
New York	448	$31.46	$21.52	7
Michigan	352	$27.66	$20.77	6
Virginia	351	$28.34	$20.64	8
Louisiana	322	$27.30	$20.04	10
Pennsylvania	310	$24.40	$18.49	11
Nevada	299	$26.45	$20.83	5
Mississippi	295	$25.70	$19.98	5
Indiana	295	$26.49	$20.28	4
Tennessee	283	$22.95	$20.98	7
Ohio	263	$23.46	$19.29	8
Minnesota	246	$29.08	$22.19	7
Montana	238	$26.94	$19.87	6
Massachusetts	205	$26.10	$18.03	6
New Jersey	171	$29.93	$21.85	5
Alabama	167	$26.65	$21.34	9
North Carolina	138	$27.37	$19.94	4
Kentucky	135	$26.56	$19.96	2
Missouri	124	$27.57	$19.99	6
District of Columbia	118	$29.24	$21.28	1
Utah	115	$26.38	$19.05	5
Maryland	112	$28.84	$21.14	7
Colorado	110	$25.97	$18.92	2
Arizona	88	$28.01	$20.81	3
Oregon	84	$25.45	$20.30	2
Illinois	74	$27.32	$20.34	3
Delaware	35	$26.21	$21.11	1
Washington	30	$28.52	$17.37	1
Arkansas	30	$26.20	$20.36	1
New Mexico	13	$27.13	$19.08	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
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

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.