How much does Medicare pay for CPT 92563?

Medicare allowed an average of $37.82 per service and paid $28.24 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $65.43, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 92563?

Test to assess defects in adaption to sounds. It was billed 6,833 times to 6,509 Medicare beneficiaries by 73 providers in 2024.

Which specialty bills 92563 most?

Audiologist, with 4,709 services from 49 clinicians. Next are Otolaryngology, Internal Medicine.

CPT 92563

Test to assess defects in adaption to sounds

$37.82Medicare-allowed amount per service, averaged across 6,833 services

Providers submitted

$65.43

Asking price, not received

Medicare allowed

$37.82

The fee schedule figure

Medicare paid

$28.24

Balance is patient coinsurance

Providers submitted an average of $65.43 for this code and Medicare allowed $37.82 — 1.7× 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 $28.24 (75%); the rest is the patient’s coinsurance and deductible.

Services: 6,833
Beneficiaries: 6,509
Providers billing it: 73
Total allowed: $258,424

What Medicare pays for CPT 92563

Across 6,833 services billed by 73 providers to 6,509 beneficiaries, Medicare allowed an average of $37.82 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 92563

Specialty	Services	Beneficiaries	Avg allowed	Providers
Audiologist	4,709	4,503	$37.64	49
Otolaryngology	2,107	1,991	$38.20	23
Internal Medicine	17	15	$39.80	1

92563 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	2,523	$39.76	$25.66	26
California	1,973	$38.38	$25.05	19
New Jersey	636	$38.82	$26.85	8
Florida	532	$33.52	$26.01	4
Tennessee	261	$33.96	$22.70	1
Illinois	200	$32.62	$25.04	2
Hawaii	177	$36.05	$25.43	1
Rhode Island	154	$35.29	$25.37	1
Pennsylvania	136	$34.20	$24.35	2
Virginia	69	$33.39	$24.38	1
Puerto Rico	40	$33.90	$23.90	2
Maryland	38	$33.37	$23.90	2
Ohio	37	$31.08	$25.26	1
Oregon	35	$33.47	$25.93	1
Washington	11	$35.35	$24.68	1
Oklahoma	11	$30.28	$27.11	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.