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See a sample rate comparisonCPT 92553 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office |
| Common Modifiers | 52 - Reduced Services EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | $49.10 national non-facility rate (2026) · View Medicare rates for 92553 |
| Medicaid Fee Schedule | $39.455 median of the 8 states in the free preview · View Medicaid rates for 92553 |
National average reimbursement for CPT 92553 by major payers:
$52.21
$45.82
$50.30
$64.24
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CPT 92553
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$253.85Published rateMark Alter
$72.69Published rateJyoti Shah
Northshore University Healthsystem Faculty Practice Associates
$59.68Published rateLubov Romantseva
Veterans Assistance Commission C
$44.00Published rateJocelyn Lorenzo
$25.42Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92553 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92553 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 92553 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 |
|---|---|---|
| 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. |
| 92553-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. |
| 92555-CPT | Low | Speech Audiometry;Threshold Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92553 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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