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See a sample rate comparisonCPT 92542 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.
Positional Nystagmus Test Min, Positional Nystagmus Test Minimum Of 4 Positionswithrecording Positional Nystagmus Test Minimum Of 4 Positions With
| 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 | 59 - Distinct Procedural Service GA - Required ABN issued and on file |
| Complexity Level | Low |
| Medicare Fee Schedule | $28.39 national non-facility rate (2026) · View Medicare rates for 92542 |
| Medicaid Fee Schedule | $23.58 median of the 8 states in the free preview · View Medicaid rates for 92542 |
National average reimbursement for CPT 92542 by major payers:
$39.05
$46.71
$45.44
$51.49
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CPT 92542
5 of 25 sample ratesHigher to lower in this preview
Jeremy Wong
University Physicians Incorporated
$104.83Published rateLance Holemon
$54.66Published rateBradley Cutler
Edward Health Ventures
$44.61Published rateCamilla Grant
Town Center Orthopaedic Associates, P.C.
$22.79Published rateDhruv Pateder
Town Center Orthopaedic Associates, P.C.
$4.67Published rate
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See a sample payer proposalCPT 92542 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92542 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 92542 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 |
|---|---|---|
| 92541-CPT | Low | Spontaneous Nystagmus Test In, Spontaneous Nystagmus Test Including Gaze And Fixationnystagmus With Recording Spontaneous Nystagmus Test Including Gaze And Fixation |
| 92542-CPT | Low | Positional Nystagmus Test Min, Positional Nystagmus Test Minimum Of 4 Positionswithrecording Positional Nystagmus Test Minimum Of 4 Positions With |
| 92544-CPT | Low | Optokinetic Nystagmus Test Bi, Optokinetic Nystagmus Test Bidirectional Foveal Orperipheral Stimulation With Recording Optokinetic Nystagmus Test Bidirectional Foveal Or |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92542. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92542 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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