CPT code 95921: Autonomic testing, parasympathetic function2026 Medicare rate & RVUs in North Carolina

Reports autonomic testing of parasympathetic function, such as heart-rate responses to deep breathing or a Valsalva maneuver, during evaluation of autonomic symptoms.

CMS RVU26DEffective Oct 1, 2026One payment locality60K Medicare services in 2024

In North Carolina, Medicare pays $85.72 for 95921 in the office.

$85.72Office (non-facility)
Not available in this settingHospital or facility
−4.9%vs the national office rate ($90.18)

Check a contract rate as a % of Medicare · 95921 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 95921 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 95921 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 95921 covers

This service assesses parasympathetic control of heart rate, commonly by recording the heart-rate response to deep breathing or a Valsalva maneuver. Neurologists and clinicians specializing in autonomic disorders may order it when evaluating suspected autonomic neuropathy or symptoms such as unexplained lightheadedness or fainting. Testing is generally performed in an autonomic or neurophysiology laboratory with ECG monitoring and trained staff.

Report 95921 when the documented service evaluates parasympathetic function; the record should identify the tests performed, the clinical indication, recorded findings, and the interpreting clinician’s conclusions. It may be billed globally when one provider or entity supplies both the testing resources and interpretation. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. CMS separately prices these component claims.

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 North Carolina compares for 95921

Across 109 of 109 payment localities, the office rate for 95921 runs from $81.15 in Arkansas to $119.07 in San Benito County, CA. North Carolina pays $85.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

95921 in North Carolina vs other payment areas
  1. North Carolina · this page$85.72
  2. Los Angeles, CA · California$101.82+$16.10
  3. Washington, DC area · District of Columbia$102.50+$16.78
  4. Miami, FL · Florida$94.66+$8.94
  5. Chicago, IL · Illinois$92.42+$6.70
  6. Manhattan, NY · New York$102.48+$16.76
  7. Alaska · Alaska$108.14+$22.42

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

Every other payment area

95921 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$82.17—
ArkansasArkansas$81.15—
ArizonaArizona$88.15—
Bakersfield, CACalifornia$95.93—
Chico, CACalifornia$95.77—
El Centro, CACalifornia$95.78—
Fresno, CACalifornia$95.77—
Hanford, CACalifornia$95.77—

95921 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.

$81.15

$108.14

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

View every state and territory as a table
95921 office rate range by state
State / territoryOffice rate rangeLocalities
AK$108.141
AL$82.171
AR$81.151
AZ$88.151
CA$95.77–$119.0729
CO$94.051
CT$95.631
DC$102.501
DE$89.481
FL$88.24–$94.663
GA$84.02–$91.492
GU$97.771
HI$97.771
IA$84.321
ID$84.721
IL$85.76–$93.024
IN$85.161
KS$83.811
KY$83.471
LA$83.29–$86.862
MA$93.53–$102.772
MD$91.08–$102.503
ME$84.92–$89.152
MI$85.18–$89.022
MN$90.971
MO$81.94–$87.333
MS$81.571
MT$90.181
NC$85.721
ND$89.391
NE$84.771
NH$92.451
NJ$96.96–$101.642
NM$85.521
NV$90.021
NY$86.81–$104.455
OH$85.021
OK$83.521
OR$89.55–$96.912
PA$85.23–$93.412
PR$90.821
RI$92.561
SC$85.461
SD$89.301
TN$84.151
TX$84.74–$93.548
UT$86.481
VA$88.78–$102.502
VI$90.821
VT$88.931
WA$93.40–$104.902
WI$86.761
WV$82.971
WY$89.841

See 95921 in every payment locality

How the 95921 rate is calculated

Each of 95921’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 · 95921

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.88

0.88 RVUs× 1.000 GPCI

Practice expense1.78

1.78 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

2.7000

Conversion factor

$33.4009

Medicare rate

$90.18

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,654

Code
95921
Physician work
0.88
Practice expense
1.78
Malpractice
0.04

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 95921 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.88× 1.0000.8800
Practice expense1.78× 0.9331.6607
Malpractice0.04× 0.6390.0256
Total RVUs2.5663
Conversion factor× 33.4009

Office rate, North Carolina$85.72

Office: (0.88 × 1 + 1.78 × 0.933 + 0.04 × 0.639) × $33.4009 = $85.72

Open 95921 in the RVU calculator

Payment rules and modifiers for 95921

The CMS indicators that decide how 95921 is paid alongside other services.

CMS payment indicators · 95921

Autonomic testing, parasympathetic function

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
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

95921 without 26 · national office

$90.18

Autonomic testing, parasympathetic function

95921-26 · Professional component

$44.09

Pays only the interpretation and report.

When to use modifier 26

How 95921 has changed in North Carolina

95921 · Office / nonfacility

$85.72

Effective 2026-10-01

The base rate is $6.33 higher than on 2025-10-01, moving from $79.39 to $85.72 (8.0%).

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

    $79.39changed to$85.72

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.90 changed to 0.88
    • Practice expense RVU 1.65 changed to 1.78
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $82.94changed to$79.39

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.69 changed to 1.65

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $81.58changed to$82.94

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $83.90changed to$81.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.66 changed to 1.69
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $86.84changed to$83.90

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.69 changed to 1.66
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $86.58changed to$86.84

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.66 changed to 1.69

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $83.58changed to$86.58

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.49 changed to 1.66
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $81.00changed to$83.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.41 changed to 1.49
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $81.24changed to$81.00

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.42 changed to 1.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $82.40changed to$81.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.46 changed to 1.42
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $83.21changed to$82.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.49 changed to 1.46
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $84.57changed to$83.21

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.53 changed to 1.49
    • Malpractice RVU 0.04 changed to 0.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $84.15changed to$84.57

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $85.47changed to$84.15

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.56 changed to 1.53
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $85.74changed to$85.47

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.71 changed to 1.56
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $85.74

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$85.72Not available in this settingRVU26D
2026-07-01$85.72Not available in this settingRVU26C
2026-04-01$85.72Not available in this settingRVU26B
2026-01-01$85.72Not available in this settingRVU26A
2025-10-01$79.39Not available in this settingRVU25D
2025-07-01$79.39Not available in this settingRVU25C
2025-04-01$79.39Not available in this settingRVU25B
2025-01-01$79.39Not available in this settingRVU25A
2024-10-01$82.94Not available in this settingRVU24D
2024-07-01$82.94Not available in this settingRVU24C
2024-04-01$82.94Not available in this settingRVU24B
2024-03-09$82.94Not available in this settingRVU24AR
2024-01-01$81.58Not available in this settingRVU24A
2023-10-01$83.90Not available in this settingRVU23D
2023-07-01$83.90Not available in this settingRVU23C
2023-04-01$83.90Not available in this settingRVU23B
2023-01-01$83.90Not available in this settingRVU23A
2022-10-01$86.84Not available in this settingRVU22D
2022-07-01$86.84Not available in this settingRVU22C
2022-04-01$86.84Not available in this settingRVU22B
2022-01-01$86.84Not available in this settingRVU22A
2021-10-01$86.58Not available in this settingRVU21D
2021-07-01$86.58Not available in this settingRVU21C
2021-04-01$86.58Not available in this settingRVU21B
2021-01-01$86.58Not available in this settingRVU21A
2020-10-01$83.58Not available in this settingRVU20D
2020-07-01$83.58Not available in this settingRVU20C
2020-04-01$83.58Not available in this settingRVU20B
2020-01-01$83.58Not available in this settingRVU20A
2019-10-01$81.00Not available in this settingRVU19D
2019-07-01$81.00Not available in this settingRVU19C
2019-04-01$81.00Not available in this settingRVU19B
2019-01-01$81.00Not available in this settingRVU19A
2018-10-01$81.24Not available in this settingRVU18D
2018-07-01$81.24Not available in this settingRVU18C
2018-04-01$81.24Not available in this settingRVU18B
2018-01-01$81.24Not available in this settingRVU18AR1
2017-10-01$82.40Not available in this settingRVU17D
2017-07-01$82.40Not available in this settingRVU17C
2017-04-01$82.40Not available in this settingRVU17B
2017-01-01$82.40Not available in this settingRVU17A
2016-10-01$83.21Not available in this settingRVU16D
2016-07-01$83.21Not available in this settingRVU16C
2016-04-01$83.21Not available in this settingRVU16B
2016-01-01$83.21Not available in this settingRVU16A
2015-10-01$84.57Not available in this settingRVU15D
2015-07-01$84.57Not available in this settingRVU15C
2015-04-01$84.15Not available in this settingRVU15B
2015-01-01$84.15Not available in this settingRVU15A
2014-10-01$85.47Not available in this settingRVU14D
2014-07-01$85.47Not available in this settingRVU14C
2014-04-01$85.47Not available in this settingRVU14B
2014-01-01$85.47Not available in this settingRVU14A
2013-10-01$85.74Not available in this settingRVU13D
2013-07-01$85.74Not available in this settingRVU13C
2013-04-01$85.74Not available in this settingRVU13B
2013-01-01$85.74Not available in this settingRVU13AR

Price 95921 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

95921 billing questions

When should 95921 be selected instead of 95922?

Use 95921 for testing of parasympathetic function, such as heart-rate responses to deep breathing or Valsalva. Code 95922 addresses vasomotor adrenergic function.

How does 95921 differ from 95924?

Code 95921 represents parasympathetic testing. Code 95924 is for combined parasympathetic and sympathetic adrenergic testing that includes tilt testing.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service with equipment and staff. Without either modifier, the claim represents the global service.

What documentation supports reporting 95921?

Document the clinical reason for testing, the parasympathetic maneuvers performed, the recorded responses, and the interpretation. The record should make clear that the service evaluated parasympathetic function.

Is 95923 another code for parasympathetic testing?

No. Code 95923 is for sudomotor autonomic testing, which assesses sweat-related function; 95921 evaluates parasympathetic function.

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 95921PPRRVU2026_Oct_nonQPP.csv, line 12,654 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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