Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 92556 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.
Speech Audiomet;Threshold/Discrmntn
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $46.43 national non-facility rate (2026) · View Medicare rates for 92556 |
| Medicaid Fee Schedule | $37.30 median of the 8 states in the free preview · View Medicaid rates for 92556 |
National average reimbursement for CPT 92556 by major payers:
$50.66
$43.92
$48.94
$62.10
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 92556.
CPT 92556
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$279.42Published rateNeil Jariwala
$74.48Published rateVictor Patron Romero
$69.94Published rateAndrea Pardo
Pediatric Faculty Foundation In
$58.56Published rateJocelyn Lorenzo
$21.85Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 92556 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92556 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 92556 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 |
|---|---|---|
| 92555-CPT | Low | Speech Audiometry;Threshold Only |
| 92556-CPT | Low | Speech Audiomet;Threshold/Discrmntn |
| 92557-CPT | Low | Series Of Hearing Tests, A Series Of Hearing Tests That Measures Both Speech And Sound Levels. The Tests Record The Lowest Level At Which Speech Can Be Identified. They Also Record The Quietest Sound That Can Be Heard (Audiometry). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92556 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 92556) and we'll show you how you compare in 15 minutes or less.