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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Otorhinolaryngologic Services and Procedures |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $31.40 national non-facility rate (2026) · View Medicare rates for 92570 |
| Medicaid Fee Schedule | $25.73 median of the 8 states in the free preview · View Medicaid rates for 92570 |
National average reimbursement for CPT 92570 by major payers:

$39.09

$41.96

$41.61

$59.25
Choose a payer to see a sample of rates for CPT 92570.
Lauren Schumacher
Syed Khan
Loyola University Medical Center
Laura Murphy
Advocate Health And Hospitals Corporation
Maria Fisfalen
Mount Sinai Community Foundation
Amanda Field
Town Center Orthopaedic Associates, P.C.
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Rate Benchmarking
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See a sample payer proposalCPT 92570 vs. Other Special Otorhinolaryngologic Services and Procedures Codes
The CPT 92570 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 92570 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 |
|---|---|---|
| 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). |
| 92571-CPT | Low | Speech Filtering Test, This Test Measures A Persons Ability To Filter Out And Identify Individual Words. Recorded Speech Is Played Through Headphones Into One Ear And Both Ears. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 92570. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 92570 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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