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See a sample rate comparisonCPT 92568 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.
Middle Ear Reflex Test, Acoustic Reflex Testing Measures Movement Of The Middle Ear In Response To Sound. This Helps To Identify Where A Hearing Problem May Be Located. Testing Can Look At Volume Level (Threshold) Or Length Of Response To A Sound (Decay).
| 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 | 59 - Distinct Procedural Service 52 - Reduced Services |
| Complexity Level | Low |
| Medicare Fee Schedule | $15.36 national non-facility rate (2026) · View Medicare rates for 92568 |
| Medicaid Fee Schedule | $12.555 median of the 8 states in the free preview · View Medicaid rates for 92568 |
National average reimbursement for CPT 92568 by major payers:
$20.04
$20.89
$19.94
$24.85
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CPT 92568
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateAndrea Pardo
Pediatric Faculty Foundation In
$33.40Published rateAbby Fredrickson
$31.31Published rateAlyssa Stram
$27.61Published rateJohn Beck
Carle Health Care Incorporated
$15.18Published rate
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See a sample payer proposalCPT 92568 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92568 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 92568 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 |
|---|---|---|
| 92567-CPT | Low | Tympanom.(Impedance Tsting) |
| 92568-CPT | Low | Middle Ear Reflex Test, Acoustic Reflex Testing Measures Movement Of The Middle Ear In Response To Sound. This Helps To Identify Where A Hearing Problem May Be Located. Testing Can Look At Volume Level (Threshold) Or Length Of Response To A Sound (Decay). |
| 92570-CPT | Low | Hearing Tests, This Hearing Test Checks Eardrum Movement In Response To Sound. The Test Checks The Middle Ear In Relation To Volume Level (Threshold) And Length Of Time A Sound Is Heard (Decay). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92568. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92568 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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