CPT code 95926: Somatosensory testing, lower-limb short latency2026 Medicare rate & RVUs in Maine
Reports short-latency evoked-potential testing of sensory pathways from the lower limbs to the central nervous system.
Medicare pays $125.98–$134.28 for 95926 in the office in Maine, from Rest of Maine to Southern Maine, ME. 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 95926 covers
This study evaluates sensory signal conduction from lower-limb peripheral nerves through the spinal cord toward the brain. A technologist applies electrical stimulation, commonly at a peripheral nerve, while recording responses at selected sites; a qualified physician interprets the waveforms and findings. Neurologists and other clinicians may use the results when assessing suspected sensory pathway dysfunction, including possible spinal cord disease, or during selected procedures requiring neurophysiologic monitoring.
Select this code when the documented study tests short-latency somatosensory responses from the lower limbs. The record should identify the nerves or sites stimulated, recording locations, waveforms obtained, and the physician’s interpretation. CMS recognizes separate professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service. The code is priced as bilateral, so modifier 50 does not increase payment.
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 95926 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $125.98 | Unavailable |
| Southern Maine, ME | $134.28 | Unavailable |
How the 95926 rate is calculated
Each of 95926’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 · 95926
RVUs × geographic indexes × conversion factor
Work0.53
0.53 RVUs× 1.000 GPCI
Practice expense3.49
3.49 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
4.0700
Conversion factor
$33.4009
Medicare rate
$135.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95926
The CMS indicators that decide how 95926 is paid alongside other services.
CMS payment indicators · 95926
Somatosensory testing, lower-limb short latency
| 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
95926 without 26 · national office
$135.94
Somatosensory testing, lower-limb short latency
95926-26 · Professional component
$26.05
Pays only the interpretation and report.
95926 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95925Evoked potentialUpper limbs
- Use 95925 for upper-limb sensory pathways; use 95926 for lower-limb pathways.
- 95927Somatosensory testingTrunk or head
- 95927 identifies testing recorded from spinal cord or subcortical structures, while 95926 is the lower-limb short-latency study.
- 95938Sensory evoked potentialsUpper and lower limbs
- 95938 describes a different somatosensory evoked-potential approach and covers upper and lower limbs; 95926 is the short-latency lower-limb study.
- 95929Motor evoked studyLower limbs
- 95929 evaluates central motor pathways in the lower limbs. Choose 95926 when the study evaluates sensory, rather than motor, pathway responses.
95926 billing questions
How does this differ from 95925?
95926 is for short-latency somatosensory testing of lower-limb pathways. 95925 is the corresponding code for upper-limb pathways.
When would 95927 be used instead?
95927 is for short-latency somatosensory testing recorded from spinal cord or subcortical structures. Choose based on the pathway and recording level documented, rather than treating it as another lower-limb code.
Can the professional and technical services be billed separately?
Yes. Report modifier 26 for the physician’s interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
Should modifier 50 be added for testing both legs?
No. CMS prices 95926 as bilateral, and modifier 50 does not increase payment.
What documentation supports reporting 95926?
Document the lower-limb sensory pathway tested, stimulation and recording sites, responses obtained, and the interpreting physician’s findings.
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
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