How much does Medicare pay for CPT 92557?

Medicare allowed an average of $36.00 per service and paid $25.32 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $122.82, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92557?

Comprehensive hearing and speech recognition test. It was billed 1,250,129 times to 1,210,037 Medicare beneficiaries by 9,513 providers in 2024.

Does 92557 pay differently in an office than a hospital?

Yes. The allowed amount averaged $36.11 in an office setting and $30.89 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 92557 most?

Audiologist, with 1,022,263 services from 7,268 clinicians. Next are Otolaryngology, Physician Assistant, Nurse Practitioner.

CPT 92557

Comprehensive hearing and speech recognition test

$36.00Medicare-allowed amount per service, averaged across 1,250,129 services

Providers submitted

$122.82

Asking price, not received

Medicare allowed

$36.00

The fee schedule figure

Medicare paid

$25.32

Balance is patient coinsurance

Providers submitted an average of $122.82 for this code and Medicare allowed $36.00 — 3.4× 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 $25.32 (70%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $36.11
Hospital / facility: $30.89

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. 1,222,648 services were billed in an office setting and 27,481 in a facility.

Services: 1,250,129
Beneficiaries: 1,210,037
Providers billing it: 9,513
Total allowed: $45,004,644

What Medicare pays for CPT 92557

Across 1,250,129 services billed by 9,513 providers to 1,210,037 beneficiaries, Medicare allowed an average of $36.00 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 92557

Specialty	Services	Beneficiaries	Avg allowed	Providers
Audiologist	1,022,263	996,055	$36.11	7,268
Otolaryngology	201,287	188,692	$36.12	1,882
Physician Assistant	13,804	13,097	$29.90	193
Nurse Practitioner	8,922	8,492	$29.73	120
Internal Medicine	774	714	$39.05	17
Family Practice	661	657	$37.64	10
Unknown Supplier/Provider Specialty	568	543	$36.17	4
Neurology	506	501	$34.01	7
Allergy/ Immunology	322	310	$34.22	2
Plastic and Reconstructive Surgery	282	271	$35.42	2
Osteopathic Manipulative Medicine	220	205	$34.82	1
Undefined Physician type	151	139	$34.36	1
Ophthalmology	127	125	$33.99	1
Speech Language Pathologist	124	123	$36.31	3
General Surgery	80	75	$39.11	1

92557 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	122,710	$39.72	$25.81	699
California	103,382	$39.18	$25.21	601
Florida	102,507	$35.60	$25.31	621
Texas	82,095	$34.90	$25.06	696
Pennsylvania	64,021	$35.26	$25.09	491
Massachusetts	47,966	$37.63	$24.57	279
New Jersey	44,663	$39.02	$25.91	236
Illinois	42,573	$35.75	$24.83	344
Maryland	42,556	$37.38	$24.92	266
Ohio	38,502	$33.29	$23.93	381
North Carolina	37,143	$34.38	$24.74	353
Virginia	35,836	$35.91	$24.53	252
Georgia	34,834	$34.70	$24.81	300
Arizona	32,780	$34.87	$25.06	225
Tennessee	26,790	$33.32	$24.62	257
Michigan	26,157	$34.47	$24.74	286
Washington	24,708	$36.51	$24.12	199
Colorado	23,371	$35.88	$24.37	224
South Carolina	22,316	$34.10	$24.75	144
Missouri	21,665	$34.12	$24.15	181
Indiana	20,929	$33.75	$24.50	225
Minnesota	17,671	$35.33	$23.90	203
Connecticut	16,179	$37.58	$25.43	138
Alabama	15,901	$32.85	$25.46	165
Wisconsin	15,111	$34.21	$23.72	174
Oklahoma	14,769	$33.21	$24.69	90
Kansas	14,715	$33.74	$24.60	108
Mississippi	12,826	$32.84	$25.27	70
Louisiana	12,583	$34.17	$25.17	132
Oregon	12,258	$35.71	$24.29	117
Kentucky	12,240	$33.29	$24.43	124
Iowa	10,956	$33.51	$24.60	106
Arkansas	10,079	$32.81	$24.81	65
Nebraska	8,711	$33.93	$24.63	78
Utah	7,286	$34.41	$24.76	91
Delaware	6,855	$35.67	$25.17	33
New Hampshire	6,747	$34.57	$23.21	45
Nevada	6,047	$34.78	$25.34	46
Idaho	5,909	$32.75	$23.42	60
New Mexico	5,512	$34.61	$24.82	43
Montana	5,302	$35.03	$23.44	37
Maine	5,028	$34.50	$23.70	52
Hawaii	4,375	$37.01	$24.82	27
Rhode Island	4,288	$36.18	$25.52	36
South Dakota	4,208	$34.26	$23.49	40
West Virginia	3,985	$33.55	$24.63	46
Vermont	2,795	$34.42	$22.18	22
North Dakota	2,329	$34.10	$23.00	20
District of Columbia	2,290	$39.14	$25.27	19
Wyoming	2,200	$35.60	$24.25	21
Alaska	1,971	$42.58	$24.63	12
Puerto Rico	974	$35.63	$24.09	29
U.S. Virgin Islands	332	$35.74	$22.85	2
Guam	153	$37.77	$21.81	1
Northern Mariana Islands	40	$36.81	$18.09	1

Related codes

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
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.