CPT code 95865: Laryngeal EMG, needle study2026 Medicare rate & RVUs in Delaware

Needle laryngeal EMG samples electrical activity in laryngeal muscles to assess suspected nerve or muscle dysfunction affecting voice or vocal-fold movement.

CMS RVU26DEffective Oct 1, 2026One payment locality1.5K Medicare services in 2024

In Delaware, Medicare pays $152.43 for 95865 in the office.

$152.43Office (non-facility)
Not available in this settingHospital or facility
−0.8%vs the national office rate ($153.64)

Check a contract rate as a % of Medicare · 95865 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 95865 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 95865 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 95865 covers

A needle electrode records electrical activity in laryngeal muscles at rest and during task activation. Physicians use the study to assess suspected laryngeal nerve or muscle dysfunction, including vocal-fold weakness or immobility and certain cases of unexplained dysphonia. It is typically performed by an otolaryngologist with laryngology expertise or a physician experienced in electrodiagnostic testing, often in an outpatient setting or a hospital clinic.

Report 95865 for the laryngeal needle examination, rather than an extremity or other-site EMG code. The record should identify the clinical indication, muscles examined, findings, and physician interpretation. CMS prices this code as bilateral, so modifier 50 does not increase payment. For split professional and technical billing, modifier 26 identifies the interpretation and modifier TC identifies the equipment and staff; billing without either modifier represents the global service.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Delaware compares for 95865

Across 109 of 109 payment localities, the office rate for 95865 runs from $138.27 in Arkansas to $202.17 in San Benito County, CA. Delaware pays $152.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

95865 in Delaware vs other payment areas
  1. Delaware · this page$152.43
  2. Los Angeles, CA · California$173.12+$20.69
  3. Washington, DC area · District of Columbia$174.48+$22.05
  4. Miami, FL · Florida$161.82+$9.39
  5. Chicago, IL · Illinois$157.96+$5.53
  6. Manhattan, NY · New York$174.66+$22.23
  7. Alaska · Alaska$184.49+$32.06

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

95865 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$140.00—
ArkansasArkansas$138.27—
ArizonaArizona$150.16—
Bakersfield, CACalifornia$163.16—
Chico, CACalifornia$162.86—
El Centro, CACalifornia$162.87—
Fresno, CACalifornia$162.86—
Hanford, CACalifornia$162.86—

95865 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$138.27

$184.49

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95865 office rate range by state
State / territoryOffice rate rangeLocalities
AK$184.491
AL$140.001
AR$138.271
AZ$150.161
CA$162.86–$202.1729
CO$160.061
CT$162.921
DC$174.481
DE$152.431
FL$150.59–$161.823
GA$143.37–$155.932
GU$166.201
HI$166.201
IA$143.541
ID$144.251
IL$146.46–$158.764
IN$144.981
KS$142.731
KY$142.331
LA$142.05–$148.122
MA$159.21–$174.822
MD$155.13–$174.483
ME$144.64–$151.762
MI$145.30–$151.982
MN$154.661
MO$139.79–$148.863
MS$139.061
MT$153.641
NC$145.991
ND$152.061
NE$144.291
NH$157.401
NJ$165.14–$173.022
NM$145.891
NV$153.301
NY$147.86–$178.085
OH$144.981
OK$142.361
OR$152.45–$164.862
PA$145.31–$159.172
PR$154.701
RI$157.621
SC$145.651
SD$151.871
TN$143.321
TX$144.47–$159.238
UT$147.381
VA$151.16–$174.482
VI$154.701
VT$151.331
WA$158.96–$178.382
WI$147.601
WV$141.711
WY$152.951

See 95865 in every payment locality

How the 95865 rate is calculated

Each of 95865’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 95865

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.53

1.53 RVUs× 1.000 GPCI

Practice expense2.99

2.99 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

4.6000

Conversion factor

$33.4009

Medicare rate

$153.64

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,588

Code
95865
Physician work
1.53
Practice expense
2.99
Malpractice
0.08

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 95865 in Delaware
ComponentRVULocality factorAdjusted
Physician work1.53× 1.0051.5376
Practice expense2.99× 0.9882.9541
Malpractice0.08× 0.8990.0719
Total RVUs4.5637
Conversion factor× 33.4009

Office rate, Delaware$152.43

Office: (1.53 × 1.005 + 2.99 × 0.988 + 0.08 × 0.899) × $33.4009 = $152.43

Open 95865 in the RVU calculator

Payment rules and modifiers for 95865

The CMS indicators that decide how 95865 is paid alongside other services.

CMS payment indicators · 95865

Laryngeal EMG, needle study

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

95865 without 26 · national office

$153.64

Laryngeal EMG, needle study

95865-26 · Professional component

$83.17

Pays only the interpretation and report.

When to use modifier 26

How 95865 has changed in Delaware

95865 · Office / nonfacility

$152.43

Effective 2026-10-01

The base rate is $11.75 higher than on 2025-10-01, moving from $140.68 to $152.43 (8.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $140.68changed to$152.43

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.57 changed to 1.53
    • Practice expense RVU 2.73 changed to 2.99
    • Malpractice RVU 0.06 changed to 0.08
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $148.06changed to$140.68

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.82 changed to 2.73
    • Malpractice RVU 0.07 changed to 0.06

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $145.65changed to$148.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $152.03changed to$145.65

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949
  5. January 1, 2023

    RVU23A

    $160.09changed to$152.03

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.91 changed to 2.82
    • Malpractice RVU 0.08 changed to 0.07
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $162.20changed to$160.09

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.95 changed to 2.91
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $159.07changed to$162.20

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.68 changed to 2.95
    • Malpractice RVU 0.09 changed to 0.06
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $155.72changed to$159.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.59 changed to 2.68
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $153.02changed to$155.72

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.51 changed to 2.59
    • Malpractice RVU 0.10 changed to 0.09

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $152.12changed to$153.02

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.47 changed to 2.51
    • Malpractice RVU 0.11 changed to 0.10
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $149.77changed to$152.12

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.39 changed to 2.47
    • Malpractice RVU 0.12 changed to 0.11
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $149.90changed to$149.77

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.40 changed to 2.39
    • Malpractice RVU 0.10 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $149.15changed to$149.90

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $140.67changed to$149.15

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.21 changed to 2.40
    • Malpractice RVU 0.05 changed to 0.10
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $140.09changed to$140.67

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.39 changed to 2.21
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $140.09

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$152.43Not available in this settingRVU26D
2026-07-01$152.43Not available in this settingRVU26C
2026-04-01$152.43Not available in this settingRVU26B
2026-01-01$152.43Not available in this settingRVU26A
2025-10-01$140.68Not available in this settingRVU25D
2025-07-01$140.68Not available in this settingRVU25C
2025-04-01$140.68Not available in this settingRVU25B
2025-01-01$140.68Not available in this settingRVU25A
2024-10-01$148.06Not available in this settingRVU24D
2024-07-01$148.06Not available in this settingRVU24C
2024-04-01$148.06Not available in this settingRVU24B
2024-03-09$148.06Not available in this settingRVU24AR
2024-01-01$145.65Not available in this settingRVU24A
2023-10-01$152.03Not available in this settingRVU23D
2023-07-01$152.03Not available in this settingRVU23C
2023-04-01$152.03Not available in this settingRVU23B
2023-01-01$152.03Not available in this settingRVU23A
2022-10-01$160.09Not available in this settingRVU22D
2022-07-01$160.09Not available in this settingRVU22C
2022-04-01$160.09Not available in this settingRVU22B
2022-01-01$160.09Not available in this settingRVU22A
2021-10-01$162.20Not available in this settingRVU21D
2021-07-01$162.20Not available in this settingRVU21C
2021-04-01$162.20Not available in this settingRVU21B
2021-01-01$162.20Not available in this settingRVU21A
2020-10-01$159.07Not available in this settingRVU20D
2020-07-01$159.07Not available in this settingRVU20C
2020-04-01$159.07Not available in this settingRVU20B
2020-01-01$159.07Not available in this settingRVU20A
2019-10-01$155.72Not available in this settingRVU19D
2019-07-01$155.72Not available in this settingRVU19C
2019-04-01$155.72Not available in this settingRVU19B
2019-01-01$155.72Not available in this settingRVU19A
2018-10-01$153.02Not available in this settingRVU18D
2018-07-01$153.02Not available in this settingRVU18C
2018-04-01$153.02Not available in this settingRVU18B
2018-01-01$153.02Not available in this settingRVU18AR1
2017-10-01$152.12Not available in this settingRVU17D
2017-07-01$152.12Not available in this settingRVU17C
2017-04-01$152.12Not available in this settingRVU17B
2017-01-01$152.12Not available in this settingRVU17A
2016-10-01$149.77Not available in this settingRVU16D
2016-07-01$149.77Not available in this settingRVU16C
2016-04-01$149.77Not available in this settingRVU16B
2016-01-01$149.77Not available in this settingRVU16A
2015-10-01$149.90Not available in this settingRVU15D
2015-07-01$149.90Not available in this settingRVU15C
2015-04-01$149.15Not available in this settingRVU15B
2015-01-01$149.15Not available in this settingRVU15A
2014-10-01$140.67Not available in this settingRVU14D
2014-07-01$140.67Not available in this settingRVU14C
2014-04-01$140.67Not available in this settingRVU14B
2014-01-01$140.67Not available in this settingRVU14A
2013-10-01$140.09Not available in this settingRVU13D
2013-07-01$140.09Not available in this settingRVU13C
2013-04-01$140.09Not available in this settingRVU13B
2013-01-01$140.09Not available in this settingRVU13AR

Price 95865 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

95865 billing questions

When should 95865 be used instead of a cranial nerve muscle EMG code?

Use 95865 when the needle examination evaluates laryngeal muscles. Codes 95867 and 95868 describe needle EMG of cranial nerve-innervated muscles, not a laryngeal study.

Does CMS pay more when modifier 50 is added?

No. CMS prices 95865 as bilateral, and modifier 50 does not increase payment.

How are the professional and technical portions reported?

Use modifier 26 for the professional interpretation and modifier TC for the technical portion. Without either modifier, the claim represents the global service.

What documentation supports reporting 95865?

Document the reason for the study, the laryngeal muscles examined, the observed electrical findings, and the physician's interpretation.

Is 95865 the same as a limited needle EMG?

No. 95865 identifies a laryngeal study; 95870 describes a limited needle examination of muscles outside this laryngeal-specific code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 95865PPRRVU2026_Oct_nonQPP.csv, line 12,588 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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