How much does Medicare pay for CPT 92555?

Medicare allowed an average of $28.55 per service and paid $20.99 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $52.09, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92555?

Test for ability to detect and repeat spoken words. It was billed 8,900 times to 8,651 Medicare beneficiaries by 228 providers in 2024.

Does 92555 pay differently in an office than a hospital?

Yes. The allowed amount averaged $28.56 in an office setting and $26.92 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 92555 most?

Audiologist, with 8,035 services from 198 clinicians. Next are Otolaryngology, Nurse Practitioner, Physician Assistant.

CPT 92555

Test for ability to detect and repeat spoken words

$28.55Medicare-allowed amount per service, averaged across 8,900 services

Providers submitted

$52.09

Asking price, not received

Medicare allowed

$28.55

The fee schedule figure

Medicare paid

$20.99

Balance is patient coinsurance

Providers submitted an average of $52.09 for this code and Medicare allowed $28.55 — 1.8× 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 $20.99 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $28.56
Hospital / facility: $26.92

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. 8,865 services were billed in an office setting and 35 in a facility.

Services: 8,900
Beneficiaries: 8,651
Providers billing it: 228
Total allowed: $254,095

What Medicare pays for CPT 92555

Across 8,900 services billed by 228 providers to 8,651 beneficiaries, Medicare allowed an average of $28.55 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 92555

Specialty	Services	Beneficiaries	Avg allowed	Providers
Audiologist	8,035	7,845	$28.62	198
Otolaryngology	677	629	$28.36	22
Nurse Practitioner	126	116	$26.27	4
Physician Assistant	35	34	$25.32	2
Family Practice	27	27	$27.07	2

92555 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
Pennsylvania	709	$27.93	$20.78	12
Maryland	705	$33.51	$21.47	22
California	672	$34.55	$20.49	10
Michigan	592	$26.75	$21.97	8
Indiana	582	$26.23	$21.82	10
New York	544	$32.55	$21.07	17
Kentucky	533	$24.66	$20.72	6
Georgia	468	$26.83	$21.72	9
Illinois	440	$28.37	$20.66	9
Tennessee	438	$25.42	$19.86	17
Louisiana	292	$25.13	$18.69	5
Ohio	265	$26.59	$21.93	6
Texas	253	$27.15	$20.34	11
Oklahoma	225	$25.19	$19.20	4
Massachusetts	204	$31.53	$21.18	8
Florida	194	$27.71	$21.85	8
Minnesota	184	$28.79	$21.94	4
Virginia	180	$29.93	$20.31	8
Colorado	154	$29.60	$21.65	5
Kansas	130	$25.33	$21.85	4
Washington	123	$31.53	$21.20	3
Connecticut	108	$30.99	$21.58	5
Montana	104	$28.55	$18.12	1
Missouri	95	$26.48	$19.63	4
New Jersey	92	$31.73	$19.03	6
West Virginia	74	$25.94	$21.62	3
Alabama	70	$24.49	$22.00	1
North Carolina	62	$26.57	$20.86	4
Arizona	54	$28.63	$21.45	1
Alaska	46	$25.93	$22.54	1
Wisconsin	45	$26.78	$17.94	2
Delaware	32	$28.22	$21.98	1
New Mexico	30	$25.91	$16.84	1
Rhode Island	29	$27.47	$22.15	1
Mississippi	26	$24.20	$21.95	2
District of Columbia	24	$33.17	$21.43	2
Idaho	21	$25.70	$21.14	1
Maine	21	$29.18	$20.53	1
South Carolina	21	$26.84	$22.66	1
Oregon	20	$27.91	$20.43	1
Nebraska	15	$25.67	$18.65	1
Iowa	13	$25.69	$18.56	1
North Dakota	11	$28.38	$18.58	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.