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

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 Puerto Rico, Medicare pays $154.70 for 95865 in the office.

$154.70Office (non-facility)
Not available in this settingHospital or facility
+0.7%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $154.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

95865 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$154.70
  2. Los Angeles, CA · California$173.12+$18.42
  3. Washington, DC area · District of Columbia$174.48+$19.78
  4. Miami, FL · Florida$161.82+$7.12
  5. Chicago, IL · Illinois$157.96+$3.26
  6. Manhattan, NY · New York$174.66+$19.96
  7. Alaska · Alaska$184.49+$29.79

Other areas in Puerto Rico 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.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 95865 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.53× 1.0001.5300
Practice expense2.99× 1.0113.0229
Malpractice0.08× 0.9850.0788
Total RVUs4.6317
Conversion factor× 33.4009

Office rate, Puerto Rico$154.70

Office: (1.53 × 1 + 2.99 × 1.011 + 0.08 × 0.985) × $33.4009 = $154.70

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

Codes related to 95865

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 95865
CodeHow it relatesOffice range, Puerto Rico
Same family
95867Needle EMG, cranial nerve muscles, one sideNeedle EMG of cranial nerve-innervated muscles on one side; a different anatomic target.$108.08
95868Needle EMG, bilateral cranial nerve musclesNeedle EMG of cranial nerve-innervated muscles on both sides; a different anatomic target.$130.21
95870Needle EMG, limited muscle studyLimited needle EMG for muscles not covered by a more specific site code.$87.30
95860Needle EMG, one extremityNeedle EMG of one extremity, rather than the larynx.$120.50
95866Diaphragm EMG, one sideNeedle EMG evaluates the hemidiaphragm, not laryngeal muscles.$137.28

How 95865 has changed in Puerto Rico

95865 · Office / nonfacility

$154.70

Effective 2026-10-01

The base rate is $13.09 higher than on 2025-10-01, moving from $141.61 to $154.70 (9.2%).

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

    $141.61changed to$154.70

    • 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
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $149.08changed to$141.61

    • 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

    $146.64changed to$149.08

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $151.86changed to$146.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $151.14changed to$151.86

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $158.57changed to$151.14

    • 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
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $160.60changed to$158.57

    • 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.

  8. January 1, 2021

    RVU21A

    $157.36changed to$160.60

    • 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
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $153.79changed to$157.36

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.59 changed to 2.68
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $151.07changed to$153.79

    • 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.

  11. January 1, 2018

    RVU18AR1

    $134.76changed to$151.07

    • 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
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $117.80changed to$134.76

    • 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
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $118.27changed to$117.80

    • 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.

  14. July 1, 2015

    RVU15C

    $117.68changed to$118.27

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $111.51changed to$117.68

    • 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 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $108.97changed to$111.51

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.39 changed to 2.21
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $108.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$154.70Not available in this settingRVU26D
2026-07-01$154.70Not available in this settingRVU26C
2026-04-01$154.70Not available in this settingRVU26B
2026-01-01$154.70Not available in this settingRVU26A
2025-10-01$141.61Not available in this settingRVU25D
2025-07-01$141.61Not available in this settingRVU25C
2025-04-01$141.61Not available in this settingRVU25B
2025-01-01$141.61Not available in this settingRVU25A
2024-10-01$149.08Not available in this settingRVU24D
2024-07-01$149.08Not available in this settingRVU24C
2024-04-01$149.08Not available in this settingRVU24B
2024-03-09$149.08Not available in this settingRVU24AR
2024-01-01$146.64Not available in this settingRVU24A
2023-10-01$151.86Not available in this settingRVU23D
2023-07-01$151.14Not available in this settingRVU23C
2023-04-01$151.14Not available in this settingRVU23B
2023-01-01$151.14Not available in this settingRVU23A
2022-10-01$158.57Not available in this settingRVU22D
2022-07-01$158.57Not available in this settingRVU22C
2022-04-01$158.57Not available in this settingRVU22B
2022-01-01$158.57Not available in this settingRVU22A
2021-10-01$160.60Not available in this settingRVU21D
2021-07-01$160.60Not available in this settingRVU21C
2021-04-01$160.60Not available in this settingRVU21B
2021-01-01$160.60Not available in this settingRVU21A
2020-10-01$157.36Not available in this settingRVU20D
2020-07-01$157.36Not available in this settingRVU20C
2020-04-01$157.36Not available in this settingRVU20B
2020-01-01$157.36Not available in this settingRVU20A
2019-10-01$153.79Not available in this settingRVU19D
2019-07-01$153.79Not available in this settingRVU19C
2019-04-01$153.79Not available in this settingRVU19B
2019-01-01$153.79Not available in this settingRVU19A
2018-10-01$151.07Not available in this settingRVU18D
2018-07-01$151.07Not available in this settingRVU18C
2018-04-01$151.07Not available in this settingRVU18B
2018-01-01$151.07Not available in this settingRVU18AR1
2017-10-01$134.76Not available in this settingRVU17D
2017-07-01$134.76Not available in this settingRVU17C
2017-04-01$134.76Not available in this settingRVU17B
2017-01-01$134.76Not available in this settingRVU17A
2016-10-01$117.80Not available in this settingRVU16D
2016-07-01$117.80Not available in this settingRVU16C
2016-04-01$117.80Not available in this settingRVU16B
2016-01-01$117.80Not available in this settingRVU16A
2015-10-01$118.27Not available in this settingRVU15D
2015-07-01$118.27Not available in this settingRVU15C
2015-04-01$117.68Not available in this settingRVU15B
2015-01-01$117.68Not available in this settingRVU15A
2014-10-01$111.51Not available in this settingRVU14D
2014-07-01$111.51Not available in this settingRVU14C
2014-04-01$111.51Not available in this settingRVU14B
2014-01-01$111.51Not available in this settingRVU14A
2013-10-01$108.97Not available in this settingRVU13D
2013-07-01$108.97Not available in this settingRVU13C
2013-04-01$108.97Not available in this settingRVU13B
2013-01-01$108.97Not available in this settingRVU13AR

Price 95865 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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