CPT code 95919: Pupillometry, one or both pupils2026 Medicare rate & RVUs

Medicare pays $16.70 for 95919 nationally in the office. Local office rates run $14.96–$21.48.

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

What 95919 covers

This service uses a quantitative pupillometer to measure pupil characteristics and responses, rather than relying only on a visual examination. A physician or other qualified health care professional interprets the measurements and prepares a report. Neurology and neurocritical care teams may use it when assessing neurologic status, including in patients with acute brain injury or altered responsiveness. It may be performed in an office or hospital setting, depending on the patient’s care.

Report the service for quantitative pupillometry of one or both eyes; the code covers either extent. Documentation should identify the clinical reason for testing, the measurements obtained, and the interpretation and report. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, while modifier TC identifies the equipment and staff portion. Reporting without either modifier represents the global service, including both components.

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 95919 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

95919 rates by state

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

How the 95919 rate is calculated

Each of 95919’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.

Payment rules and modifiers for 95919

The CMS indicators that decide how 95919 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

95919 compared with similar codes

How to choose

95921Autonomic testingParasympathetic function

Use 95919 for quantitative pupil measurements and their interpretation. Use 95921 when the service assesses parasympathetic autonomic function.

95922Autonomic testingAdrenergic function

Use 95922 for adrenergic autonomic testing, not for a quantitative assessment of pupil responses.

95923Sweat function testSudomotor testing

95923 reports autonomic function testing; 95919 reports quantitative pupillometry. Select according to the test actually performed and interpreted.

95924Autonomic testingCombined tilt-table protocol

95924 describes combined parasympathetic and sympathetic testing with tilt. It is not a substitute for reporting quantitative pupil measurements.

Codes related to 95919

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

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

Open CMS sourceHow we calculate rates