CPT code 95865: Laryngeal EMG, needle study2026 Medicare rate & RVUs in Missouri
Needle laryngeal EMG samples electrical activity in laryngeal muscles to assess suspected nerve or muscle dysfunction affecting voice or vocal-fold movement.
Medicare pays $139.79–$148.86 for 95865 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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.
Where 95865 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$139.79 to $148.86
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $147.49 | Unavailable |
| Metropolitan St. Louis, MO | $148.86 | Unavailable |
| Rest of Missouri | $139.79 | Unavailable |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
95865 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95867Needle EMGCranial nerve muscles, one side
- 95865 is specific to laryngeal muscles. Use 95867 for a unilateral needle examination of other cranial nerve-innervated muscles.
- 95868Needle EMGBilateral cranial nerve muscles
- 95868 covers bilateral cranial nerve muscle examination outside the larynx; 95865 is the laryngeal-specific study and is already priced as bilateral.
- 95870Needle EMGLimited muscle study
- 95870 is for a limited needle examination of muscles without a more specific site code. Select 95865 when the study targets laryngeal muscles.
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.
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