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See a sample rate comparisonCPT 92538 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Diag Ear/Nose/Throat Proc, Caloric Vestibular Test With Recording Bilateral; Bithermal (Ie One Warm And One Cool Irrigation In Each Ear For A Total Of Four Irrigations)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $21.71 national non-facility rate (2026) · View Medicare rates for 92538 |
| Medicaid Fee Schedule | $17.565 median of the 8 states in the free preview · View Medicaid rates for 92538 |
National average reimbursement for CPT 92538 by major payers:
$26.59
$28.10
$28.64
$42.63
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CPT 92538
5 of 25 sample ratesHigher to lower in this preview
Adam Rappoport
The Nemours Foundation
$55.40Published rateAngela Green
Loyola University Medical Center
$31.12Published rateOyoyo Sawyer
District Medical Group Inc
$18.55Published rateOday Alsarraf
Swedishamerican Hospital
$10.48Published rateRandy Jung
Touchette Regional Hospital Inc
$4.13Published rate
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See a sample payer proposalCPT 92538 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92538 code is part of the Medicine Services and Procedures services used for Special Otorhinolaryngologic Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 92538 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 92537-CPT | Low | Caloric Vestibular Test With R, Caloric Vestibular Test With Recording Bilateralbithermal (Ie One Warm And One Cool Irrigation I N Each Ear For A Total Of Four Irrigations) |
| 92538-CPT | Low | Diag Ear/Nose/Throat Proc, Caloric Vestibular Test With Recording Bilateral; Bithermal (Ie One Warm And One Cool Irrigation In Each Ear For A Total Of Four Irrigations) |
| 92540-CPT | Low | Basic Vestibular Evaluation, Basic Vestibular Evaluation Includes Spontaneous Nystagmus Test With Eccentric Gaze Fixation Nystagmus With Recording Positional Nystagmus Test Minimum Of 4 Positions With Recording Optokinetic Nystagmus Test Bidirectional Foveal And Peripheral Stimulation With Recording And Oscillating Tracking Test With Recording |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92538. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92538 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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