| Category | Amount |
|---|---|
| Medicare Allowed Rate What Medicare approves for this service | $36.78 |
| Typical Billed Amount What providers commonly charge | $80 – $200 |
| Potential Markup How much more you might pay vs. Medicare rate | ~250% above Medicare |
What CPT 92557 Means and When It's Used
CPT code 92557 is the standard comprehensive audiometry evaluation. It bundles three tests that together describe how well you hear: pure-tone air conduction (the soft beeps you press a button for), pure-tone bone conduction (a vibrating headband that bypasses the outer and middle ear), and speech audiometry (repeating words at different volumes).
An audiologist or ENT physician uses 92557 when you're being evaluated for hearing loss, tinnitus, or any concern about how well you hear. The result is an audiogram — the graph that shows your hearing thresholds across different pitches in each ear — and a speech recognition score. Together, these confirm whether hearing loss is present, what type (sensorineural, conductive, or mixed), and how severe.
92557 is almost always the starting point for a hearing aid fitting, a cochlear implant candidacy workup, or any insurance claim involving hearing loss. Without a 92557 on file, downstream services like a hearing aid evaluation (CPT 92626) generally can't be billed.
Understanding Your Bill for CPT 92557
When you see CPT code 92557 on your medical bill, you can expect charges typically ranging from $80 to $200, depending on the provider, location, and whether the test is done in a private practice, hospital outpatient department, or ENT office. Medicare's national allowed amount is approximately $36.78, which gives you a useful baseline.
Your actual out-of-pocket cost depends heavily on your plan. Original Medicare covers 92557 when ordered by a physician for diagnostic purposes — but it does not cover hearing tests done purely to fit a hearing aid. Many Medicare Advantage plans include hearing benefits with low or $0 copays for diagnostic audiometry; commercial plans vary widely.
If a 92557 shows up on a bill from a hearing aid retailer, look closely. Some retailers offer the test "free" but bundle the cost into the device price. Others bill insurance for the test even when the visit was framed as a free screening — make sure the test you actually had matches what's on the bill.
How to Verify Your CPT 92557 Charges
Start by checking that you actually had a comprehensive audiometric evaluation, not a brief screening. A 92557 should include all three components — pure-tone air conduction, pure-tone bone conduction, and speech recognition — in both ears. If you only had a pure-tone test (no speech words), the correct code is 92552 or 92553, not 92557.
Next, confirm that the order came from a qualifying provider. Medicare requires a physician order for diagnostic audiometry to be covered. If you walked into an audiology clinic without a referral and 92557 was billed to Medicare anyway, the claim may be denied or your coinsurance may be higher than expected.
If the charge looks high, ask the billing department whether the test was billed to insurance with a diagnostic ICD-10 code (like H91.90 for hearing loss) or as a routine hearing screening. The same test can be covered or denied depending on how it's coded — you have the right to request the diagnosis code that was submitted with the claim.
Codes Often Confused With CPT 92557
Diagnoses Commonly Billed with This Code
This billing code often appears alongside these diagnosis codes on insurance claims:
Frequently Asked Questions
Related Diagnosis Codes
These ICD-10 diagnosis codes are commonly paired with CPT 92557 on medical bills:
Sources
- CMS: Physician Fee Schedule Search · Centers for Medicare & Medicaid Services
- AMA: CPT Code Information · American Medical Association