CPT 92557
Global XXX ActiveComprehensive hearing test
CPT 92557 Billing & Documentation Guide
CPT code 92557 (Comprehensive hearing test) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.6, a non-facility practice expense RVU of 0.46, and a malpractice RVU of 0.01, a total non-facility RVU of 1.07 and facility RVU of 0.77. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $36.77, though rates vary from $33.41 to $46.61 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92557, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 92557 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 92557 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 92557
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.6 | 0.6 |
| Practice Expense RVU | 0.46 | 0.16 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 1.07 | 0.77 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92557
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $39.12 | $27.26 | $37.4 - $44.58 | 29 |
| Florida | $36.11 | $26.05 | $35.23 - $36.88 | 3 |
| Georgia | $35.13 | $25.57 | $34.14 - $36.11 | 2 |
| Illinois | $35.6 | $25.91 | $34.59 - $36.55 | 4 |
| Michigan | $34.94 | $25.53 | $34.45 - $35.43 | 2 |
| North Carolina | $34.59 | $25.24 | $34.59 - $34.59 | 1 |
| New York | $38.59 | $27.41 | $34.87 - $40.21 | 5 |
| Ohio | $34.4 | $25.26 | $34.4 - $34.4 | 1 |
| Pennsylvania | $35.63 | $25.81 | $34.46 - $36.79 | 2 |
| Texas | $35.59 | $25.72 | $34.33 - $36.63 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 92557
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92557 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0212T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 69209 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 69210 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 92552 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 92553 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 92555 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 92556 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 92557
What does CPT code 92557 mean? +
CPT code 92557 represents: Comprehensive hearing test. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92557? +
The 2026 Medicare national average non-facility payment for CPT 92557 is $36.77. Rates range from $33.41 to $46.61 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92557? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 92557? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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