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See a sample rate comparisonCPT 92557 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.
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).
| 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 | AB - Audiology service by audiologist PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.74 national non-facility rate (2026) · View Medicare rates for 92557 |
| Medicaid Fee Schedule | $29.89 median of the 8 states in the free preview · View Medicaid rates for 92557 |
National average reimbursement for CPT 92557 by major payers:
$46.10
$52.02
$52.95
$55.49
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CPT 92557
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Upstate, Prisma Health Op Radiology
Prisma Health - Upstate
$714.11Published rateForest Health Medical Center LLC, Forest Health Medical Center
Forest Health Medical Center LLC
$254.41Published rateMarshall Medical Center
$60.00Published rateAnaheim Memorial Medical Center
$60.00Published ratePlano Ami Lp, Advanced Medical Imaging
$44.02Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 92557 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92557 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 92557 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 |
|---|---|---|
| 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). |
| 92558-CPT | Low | Evoked Otoacoustic Emissions, Evoked Otoacoustic Emissions Screening (Qualitative Measurement Of Distortion Product Or Transient Evoked Otoacoustic Emissions) Automated Analysis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92557. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92557 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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Frequently Asked Questions
To find out the cost of a medical procedure or service, it's best to look up specific information using CPT codes and your specific location. You can utilize a tool like Payerprice's fee schedule lookup tool for this purpose, as prices can vary significantly based on your provider, insurance plan, and geographic area.
A CPT (Current Procedural Terminology) code is a five-digit code used by medical professionals to describe medical, surgical, and diagnostic services. It is crucial for understanding healthcare costs because these codes are standardized, allowing you to identify and look up the specific pricing for a particular service, which is essential for billing and insurance claims.
In healthcare, a fee schedule is a comprehensive listing of fees used by insurance companies and healthcare providers to determine the payment for medical services. It outlines the maximum allowable amount that an insurer will reimburse for specific procedures or services, often identified by CPT codes.
Healthcare prices vary significantly due to multiple factors, including differences in negotiated rates between insurance companies and providers, geographic location, type of facility (e.g., hospital vs. outpatient clinic), the provider's specific charges, and the complexity of the service. These variations make it challenging for consumers to determine costs without specific tools.
To look up specific prices for medical services using CPT codes and your location, you should use a dedicated fee schedule lookup tool. Payerprice offers such a tool that allows users to search with CPT codes and specific locations to find relevant pricing information.