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See a sample rate comparisonCPT 92551 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.
Screening For Hearing Problems, Basic Screening Test For Hearing Problems Where The Individual Tested Responds To Sounds In Headphones.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | EP - Residential facility to Physician's office 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 92551 |
| Medicaid Fee Schedule | $11.19 median of the 7 states in the free preview · View Medicaid rates for 92551 |
National average reimbursement for CPT 92551 by major payers:
$15.44
$14.62
$15.67
$19.25
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CPT 92551
5 of 25 sample ratesHigher to lower in this preview
Arthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$38.40Published rateHospital Authority Of Candler County, Candler County Hospital
$20.77Published rateBrownstone Physical Therapy, P.C.
$14.00Published rateCollin Messerly
Town Center Orthopaedic Associates, P.C.
$11.72Published rateIndiana Mri Of Terre Haute, LLC
Indiana Mri Of Terre Haute LLC
$8.73Published rate
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See a sample payer proposalCPT 92551 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92551 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 92551 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 |
|---|---|---|
| 92550-CPT | Low | Hearing Tests, Two Tests That Look At The Inner Workings Of The Ear In Response To Sound. Tympanometry Checks Eardrum Movement. The Acoustic Reflex Threshold Test Checks The Middle Ear Response To Changes In Volume. |
| 92551-CPT | Low | Screening For Hearing Problems, Basic Screening Test For Hearing Problems Where The Individual Tested Responds To Sounds In Headphones. |
| 92552-CPT | Low | Hearing Test, A Hearing Test That Measures The Ability To Respond To Various Sound Frequencies (Low High). Sound Is Transmitted Through Headphones Or A Device That Vibrates Against Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92551. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92551 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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