CPT 92568
Global XXX ActiveAcoustic refl threshold tst
CPT 92568 Billing & Documentation Guide
CPT code 92568 (Acoustic refl threshold tst) is classified under Audiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.29, a non-facility practice expense RVU of 0.16, and a malpractice RVU of 0.01, a total non-facility RVU of 0.46 and facility RVU of 0.38. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $15.75, though rates vary from $14.45 to $20.4 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 92568, 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 92568 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 92568 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 92568
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.29 | 0.29 |
| Practice Expense RVU | 0.16 | 0.08 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 0.46 | 0.38 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 92568
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 | $16.54 | $13.38 | $15.89 - $18.64 | 29 |
| Florida | $15.7 | $13.02 | $15.3 - $16.09 | 3 |
| Georgia | $15.2 | $12.65 | $14.85 - $15.55 | 2 |
| Illinois | $15.52 | $12.94 | $15.09 - $15.89 | 4 |
| Michigan | $15.18 | $12.67 | $14.94 - $15.41 | 2 |
| North Carolina | $14.89 | $12.39 | $14.89 - $14.89 | 1 |
| New York | $16.56 | $13.58 | $15 - $17.28 | 5 |
| Ohio | $14.9 | $12.46 | $14.9 - $14.9 | 1 |
| Pennsylvania | $15.37 | $12.75 | $14.91 - $15.82 | 2 |
| Texas | $15.31 | $12.68 | $14.86 - $15.66 | 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 92568
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 92568 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 92567 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99201 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99202 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99203 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 99204 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 92568
What does CPT code 92568 mean? +
CPT code 92568 represents: Acoustic refl threshold tst. It's in the Audiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 92568? +
The 2026 Medicare national average non-facility payment for CPT 92568 is $15.75. Rates range from $14.45 to $20.4 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 92568? +
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 92568? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team