CPT (Current Procedural Terminology) codes are five-digit numbers that describe every medical service or procedure. Your doctor, hospital, and insurance company use them to communicate exactly what was done. Every line on your medical bill has a CPT code, and knowing the code lets you look up what Medicare pays for that same service.

Why do providers charge so much more than Medicare pays?

Providers set their own "chargemaster" prices, which are essentially list prices. Medicare pays a fixed rate based on the resources each service actually requires (the RVU system for procedures, or the Clinical Lab Fee Schedule for lab tests). Commercial insurers typically pay 150% to 250% of Medicare rates. Uninsured patients are often billed the full chargemaster price, which can be 2x to 30x what Medicare pays.

Can I use Medicare rates to negotiate my bill?

Yes. Medicare rates are the closest thing to a "fair price" benchmark in U.S. healthcare. When negotiating, ask the provider what they accept from Medicare for the same CPT code. Most providers will accept 150% to 200% of Medicare for cash-pay patients, which is still far less than their chargemaster price. Many hospital financial assistance policies also use a multiple of Medicare as their discount floor.

How are Medicare rates calculated?

For most procedures, Medicare uses the Resource-Based Relative Value Scale (RBRVS). Each CPT code gets three RVU components: Work (physician time and skill), Practice Expense (overhead), and Malpractice. These are multiplied by geographic adjustment factors (GPCIs) and a conversion factor ($33.4009 in 2026). Lab tests (80000-89999 range) use a separate Clinical Laboratory Fee Schedule with flat national rates.

CPT 92567

Tympanometry: Middle Ear Function Test

CPT 92567 covers tympanometry, a test that measures how well the eardrum moves to detect fluid or pressure problems in the middle ear. The test takes 15 to 30 seconds per ear and is performed by a technician, not the physician. Providers charge an average of $50.54, but Medicare pays only $16.03 (3.2x markup). This test is frequently added to audiograms and ear infection follow-ups, sometimes without clear clinical necessity.

Updated May 2026Source: CMS Physician Fee Schedule

CPT 92567 at a Glance

Average provider charge: $50.54
Medicare rate (office and facility): $16.03
Typical markup: 3.2x over Medicare
Test duration: 15-30 seconds per ear

Performed by: Audiology technician
What it detects: Fluid, pressure, eardrum problems
Commonly paired with: Audiogram (92557)
Beneficiaries (2023): 840,287

How the Medicare Rate Is Calculated

Medicare values every procedure using Relative Value Units (RVUs) across three components, then multiplies by a national conversion factor of $33.4009 (2026). Like the bladder scan, tympanometry has identical office and facility rates:

Component	What It Covers	Office (Non-Facility)	Hospital (Facility)
Work RVU	Physician time, skill, and judgment	0.20	0.20
Practice Expense RVU	Rent, staff, equipment, supplies	0.19	0.19
Malpractice RVU	Professional liability insurance	0.01	0.01
Total RVU		0.40	0.40
x $33.4009	2026 conversion factor	$16.03	$16.03

Often bundled with audiograms: Tympanometry is frequently performed alongside a full audiogram (CPT 92557, average charge $120). Together, these two tests can add $170+ to a hearing evaluation. The audiogram itself may be clinically necessary, but the tympanometry add-on is worth questioning if there is no suspicion of middle ear disease.

Medicare Rate by State

Medicare adjusts the national rate by location using Geographic Practice Cost Indices (GPCIs). The geographic variation for tympanometry ranges from about $11.88 in Arkansas to $15.24 in Alaska.

Medicare Rate by State (2026)

Medicare adjusts payments by location using Geographic Practice Cost Indices (GPCIs). Select your state to see the adjusted rate.

Sample State Rates

State	Medicare Pays	Avg. Charge	Markup
Texas (Austin)	$13.14	$50.54	3.8x
California (Los Angeles)	$13.76	$50.54	3.7x
New York (Manhattan)	$13.85	$50.54	3.6x
Florida (Fort Lauderdale)	$13.25	$50.54	3.8x
Ohio	$12.38	$50.54	4.1x
Mississippi	$11.96	$50.54	4.2x
Arkansas	$11.88	$50.54	4.3x
Alaska	$15.24	$50.54	3.3x

Rates shown use 2026 GPCIs and the $33.4009 conversion factor. The average provider charge of $50.54 is the 2023 national average from CMS utilization data. Actual charges vary by provider.

What Insured Patients Actually Pay

Tympanometry is typically billed alongside an office visit and possibly an audiogram. The tympanometry charge alone usually adds the following to your out-of-pocket cost:

Your Situation	What You Likely Pay	How It Works
Coinsurance plan (deductible met)	$5 to $10	20% of the negotiated rate ($25 to $50)
High-deductible plan (deductible NOT met)	$25 to $50	Full negotiated rate until deductible is met
Medicare Part B	$3.21	20% of the Medicare-approved amount ($16.03)
No insurance (self-pay)	$35 to $75	Full billed charge or cash-pay rate

Total hearing evaluation cost: A typical audiology visit with both an audiogram (92557, $120 charge) and tympanometry (92567, $51 charge) plus an office visit (99213 or 99214) can total $350 to $500 in charges. If your deductible is not met, you could owe $200+ for what feels like a routine hearing check. Ask in advance what tests will be performed and whether all are necessary.

Common Billing Problems with 92567

Automatic bundling with audiograms

Many audiology practices perform tympanometry on every patient who gets a hearing test, regardless of whether there is a clinical indication for middle ear assessment. If you are there for a routine hearing evaluation (such as for hearing aids) and have no ear pain, pressure, or history of middle ear disease, ask whether tympanometry is medically necessary or simply part of the standard battery. You can decline the test.

Unnecessary repeat testing in pediatric ear infections

In pediatric settings, tympanometry is commonly ordered at every ear infection follow-up visit. If your child's infection has resolved, they have no symptoms, and the physician confirms normal ear appearance on physical examination, a tympanometry test may not change the treatment plan. The physical exam alone (otoscopy) can often determine whether the ear has healed. Ask whether the result would actually change what your child's doctor recommends.

Performed by technician, billed under physician

Tympanometry is performed by an audiology technician or medical assistant. The test is automated and requires minimal interpretation. Yet the charge appears on the bill under the supervising audiologist or physician. While this is standard practice, it is worth understanding that no physician skill or judgment was directly involved in performing the test.

Frequently Asked Questions

How much does tympanometry (CPT 92567) cost?

Providers charge an average of $50.54 for tympanometry. Medicare pays $16.03 for this test (3.2x markup). The test takes 15 to 30 seconds per ear and is performed by a technician, not the physician. Without insurance, expect to pay $35 to $75 depending on the practice.

Is tympanometry always necessary with a hearing test?

Not always. Tympanometry is frequently bundled with audiograms (hearing tests) at audiology appointments, adding $51 to the visit. For routine hearing aid evaluations where there is no suspicion of middle ear disease (no ear pain, no pressure sensation, no history of ear infections), tympanometry may not change clinical management. Ask your audiologist whether it is necessary for your specific situation before the test is performed.

What does tympanometry actually test?

Tympanometry measures how well the eardrum (tympanic membrane) moves in response to air pressure changes. It detects fluid behind the eardrum, eustachian tube dysfunction, perforations, or problems with the middle ear bones (ossicles). A small probe is placed in the ear canal, air pressure is varied slightly, and the instrument records how the eardrum responds. The test is painless and takes about 15 to 30 seconds per ear.

Is tympanometry needed at every pediatric ear infection follow-up?

Not necessarily. If your child's ear infection has resolved, they are asymptomatic, and the physician confirms normal ear appearance on examination (using an otoscope), a tympanometry test may not change the treatment plan. It is most useful when there is uncertainty about whether fluid persists behind the eardrum. Ask whether the physical exam alone is sufficient for the follow-up before consenting to additional testing.

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