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CMS RVU26D · Effective 2026-10-01

95865 in Austin

Office / nonfacility

$159.23

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Electrodiagnostic testing

About 95865: Laryngeal needle electromyography

Needle laryngeal EMG samples electrical activity in laryngeal muscles to assess suspected nerve or muscle dysfunction affecting voice or vocal-fold movement.

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.

CMS billing rules for 95865

Professional and technical components
Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Bilateral procedures
The code is already priced as bilateral; modifier 50 does not increase payment.

Where the value comes from

  • Work RVU1.53 · 33%
  • Practice expense (office) RVU2.99 · 65%
  • Malpractice RVU0.08 · 2%

1.5K

Medicare services in 2024 · #2647 by national volume

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.

95865 compared with similar codes

Office rates for Austin, from the same CMS release.

95867

Needle EMG

Cranial nerve muscles, one side

$111.77

95865 is specific to laryngeal muscles. Use 95867 for a unilateral needle examination of other cranial nerve-innervated muscles.

95868

Needle EMG

Bilateral cranial nerve muscles

$134.26

95868 covers bilateral cranial nerve muscle examination outside the larynx; 95865 is the laryngeal-specific study and is already priced as bilateral.

95870

Needle EMG

Limited muscle study

$90.68

95870 is for a limited needle examination of muscles without a more specific site code. Select 95865 when the study targets laryngeal muscles.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 95865 is $144.47—$14.76 lower than the $159.23 rate in Austin. Both use the same code, release and participation basis.

95865 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $159.23

  2. Beaumont

    $144.47

    $14.76 lower than Austin

  3. Brazoria

    $152.57

    $6.66 lower than Austin

  4. Dallas

    $153.33

    $5.90 lower than Austin

  5. Fort Worth

    $152.36

    $6.87 lower than Austin

  6. Galveston

    $152.89

    $6.34 lower than Austin

  7. Houston

    $154.36

    $4.87 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 95865 ranges from $138.27 in Arkansas to $202.17 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 95865

    Office

    $148.29

    Facility

    Unavailable

    $10.94 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 95865

    Office

    $173.12

    Facility

    Unavailable

    $13.89 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 95865

    Office

    $174.48

    Facility

    Unavailable

    $15.25 higher than Austin for the office setting.

  • Miami

    Florida · 95865

    Office

    $161.82

    Facility

    Unavailable

    $2.59 higher than Austin for the office setting.

  • Chicago

    Illinois · 95865

    Office

    $157.96

    Facility

    Unavailable

    $1.27 lower than Austin for the office setting.

  • Manhattan

    New York · 95865

    Office

    $174.66

    Facility

    Unavailable

    $15.43 higher than Austin for the office setting.

  • Alaska*

    Alaska · 95865

    Office

    $184.49

    Facility

    Unavailable

    $25.26 higher than Austin for the office setting.

  • Alabama

    Alabama · 95865

    Office

    $140.00

    Facility

    Unavailable

    $19.23 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 95865

    Office

    $138.27

    Facility

    Unavailable

    $20.96 lower than Austin for the office setting.

  • Arizona

    Arizona · 95865

    Office

    $150.16

    Facility

    Unavailable

    $9.07 lower than Austin for the office setting.

  • Bakersfield

    California · 95865

    Office

    $163.16

    Facility

    Unavailable

    $3.93 higher than Austin for the office setting.

  • Chico

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • El Centro

    California · 95865

    Office

    $162.87

    Facility

    Unavailable

    $3.64 higher than Austin for the office setting.

  • Fresno

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Madera

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Merced

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Modesto

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Napa

    California · 95865

    Office

    $187.31

    Facility

    Unavailable

    $28.08 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 95865

    Office

    $172.24

    Facility

    Unavailable

    $13.01 higher than Austin for the office setting.

  • Redding

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Rest Of California

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 95865

    Office

    $163.76

    Facility

    Unavailable

    $4.53 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 95865

    Office

    $170.52

    Facility

    Unavailable

    $11.29 higher than Austin for the office setting.

  • Salinas

    California · 95865

    Office

    $169.87

    Facility

    Unavailable

    $10.64 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 95865

    Office

    $173.53

    Facility

    Unavailable

    $14.30 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 95865

    Office

    $198.00

    Facility

    Unavailable

    $38.77 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 95865

    Office

    $197.91

    Facility

    Unavailable

    $38.68 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 95865

    Office

    $202.17

    Facility

    Unavailable

    $42.94 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 95865

    Office

    $201.80

    Facility

    Unavailable

    $42.57 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 95865

    Office

    $167.15

    Facility

    Unavailable

    $7.92 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 95865

    Office

    $174.95

    Facility

    Unavailable

    $15.72 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 95865

    Office

    $170.41

    Facility

    Unavailable

    $11.18 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 95865

    Office

    $176.71

    Facility

    Unavailable

    $17.48 higher than Austin for the office setting.

  • Stockton

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Vallejo

    California · 95865

    Office

    $187.18

    Facility

    Unavailable

    $27.95 higher than Austin for the office setting.

  • Visalia

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Yuba City

    California · 95865

    Office

    $162.86

    Facility

    Unavailable

    $3.63 higher than Austin for the office setting.

  • Colorado

    Colorado · 95865

    Office

    $160.06

    Facility

    Unavailable

    $0.83 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 95865

    Office

    $162.92

    Facility

    Unavailable

    $3.69 higher than Austin for the office setting.

  • Delaware

    Delaware · 95865

    Office

    $152.43

    Facility

    Unavailable

    $6.80 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 95865

    Office

    $157.10

    Facility

    Unavailable

    $2.13 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 95865

    Office

    $150.59

    Facility

    Unavailable

    $8.64 lower than Austin for the office setting.

  • Atlanta

    Georgia · 95865

    Office

    $155.93

    Facility

    Unavailable

    $3.30 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 95865

    Office

    $143.37

    Facility

    Unavailable

    $15.86 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 95865

    Office

    $166.20

    Facility

    Unavailable

    $6.97 higher than Austin for the office setting.

  • Iowa

    Iowa · 95865

    Office

    $143.54

    Facility

    Unavailable

    $15.69 lower than Austin for the office setting.

  • Idaho

    Idaho · 95865

    Office

    $144.25

    Facility

    Unavailable

    $14.98 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 95865

    Office

    $148.36

    Facility

    Unavailable

    $10.87 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 95865

    Office

    $146.46

    Facility

    Unavailable

    $12.77 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 95865

    Office

    $158.76

    Facility

    Unavailable

    $0.47 lower than Austin for the office setting.

  • Indiana

    Indiana · 95865

    Office

    $144.98

    Facility

    Unavailable

    $14.25 lower than Austin for the office setting.

  • Kansas

    Kansas · 95865

    Office

    $142.73

    Facility

    Unavailable

    $16.50 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 95865

    Office

    $142.33

    Facility

    Unavailable

    $16.90 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 95865

    Office

    $148.12

    Facility

    Unavailable

    $11.11 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 95865

    Office

    $142.05

    Facility

    Unavailable

    $17.18 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 95865

    Office

    $174.82

    Facility

    Unavailable

    $15.59 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 95865

    Office

    $159.21

    Facility

    Unavailable

    $0.02 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 95865

    Office

    $162.39

    Facility

    Unavailable

    $3.16 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 95865

    Office

    $155.13

    Facility

    Unavailable

    $4.10 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 95865

    Office

    $144.64

    Facility

    Unavailable

    $14.59 lower than Austin for the office setting.

  • Southern Maine

    Maine · 95865

    Office

    $151.76

    Facility

    Unavailable

    $7.47 lower than Austin for the office setting.

  • Detroit

    Michigan · 95865

    Office

    $151.98

    Facility

    Unavailable

    $7.25 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 95865

    Office

    $145.30

    Facility

    Unavailable

    $13.93 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 95865

    Office

    $154.66

    Facility

    Unavailable

    $4.57 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 95865

    Office

    $147.49

    Facility

    Unavailable

    $11.74 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 95865

    Office

    $148.86

    Facility

    Unavailable

    $10.37 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 95865

    Office

    $139.79

    Facility

    Unavailable

    $19.44 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 95865

    Office

    $139.06

    Facility

    Unavailable

    $20.17 lower than Austin for the office setting.

  • Montana**

    Montana · 95865

    Office

    $153.64

    Facility

    Unavailable

    $5.59 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 95865

    Office

    $145.99

    Facility

    Unavailable

    $13.24 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 95865

    Office

    $152.06

    Facility

    Unavailable

    $7.17 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 95865

    Office

    $144.29

    Facility

    Unavailable

    $14.94 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 95865

    Office

    $157.40

    Facility

    Unavailable

    $1.83 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 95865

    Office

    $173.02

    Facility

    Unavailable

    $13.79 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 95865

    Office

    $165.14

    Facility

    Unavailable

    $5.91 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 95865

    Office

    $145.89

    Facility

    Unavailable

    $13.34 lower than Austin for the office setting.

  • Nevada**

    Nevada · 95865

    Office

    $153.30

    Facility

    Unavailable

    $5.93 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 95865

    Office

    $178.08

    Facility

    Unavailable

    $18.85 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 95865

    Office

    $165.99

    Facility

    Unavailable

    $6.76 higher than Austin for the office setting.

  • Queens

    New York · 95865

    Office

    $176.27

    Facility

    Unavailable

    $17.04 higher than Austin for the office setting.

  • Rest Of New York

    New York · 95865

    Office

    $147.86

    Facility

    Unavailable

    $11.37 lower than Austin for the office setting.

  • Ohio

    Ohio · 95865

    Office

    $144.98

    Facility

    Unavailable

    $14.25 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 95865

    Office

    $142.36

    Facility

    Unavailable

    $16.87 lower than Austin for the office setting.

  • Portland

    Oregon · 95865

    Office

    $164.86

    Facility

    Unavailable

    $5.63 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 95865

    Office

    $152.45

    Facility

    Unavailable

    $6.78 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 95865

    Office

    $159.17

    Facility

    Unavailable

    $0.06 lower than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 95865

    Office

    $145.31

    Facility

    Unavailable

    $13.92 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 95865

    Office

    $154.70

    Facility

    Unavailable

    $4.53 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 95865

    Office

    $157.62

    Facility

    Unavailable

    $1.61 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 95865

    Office

    $145.65

    Facility

    Unavailable

    $13.58 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 95865

    Office

    $151.87

    Facility

    Unavailable

    $7.36 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 95865

    Office

    $143.32

    Facility

    Unavailable

    $15.91 lower than Austin for the office setting.

  • Utah

    Utah · 95865

    Office

    $147.38

    Facility

    Unavailable

    $11.85 lower than Austin for the office setting.

  • Virginia

    Virginia · 95865

    Office

    $151.16

    Facility

    Unavailable

    $8.07 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 95865

    Office

    $154.70

    Facility

    Unavailable

    $4.53 lower than Austin for the office setting.

  • Vermont

    Vermont · 95865

    Office

    $151.33

    Facility

    Unavailable

    $7.90 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 95865

    Office

    $158.96

    Facility

    Unavailable

    $0.27 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 95865

    Office

    $178.38

    Facility

    Unavailable

    $19.15 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 95865

    Office

    $147.60

    Facility

    Unavailable

    $11.63 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 95865

    Office

    $141.71

    Facility

    Unavailable

    $17.52 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 95865

    Office

    $152.95

    Facility

    Unavailable

    $6.28 lower than Austin for the office setting.

See how rates vary across the country

95865 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate 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

Explore 95865 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 95865 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$175.15

$159.23 × 110% = $175.15

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95865 in Austin.

PPRRVU2026_Oct_nonQPP.csv

12,588

Code
95865
Physician work
1.53
Practice expense
2.99
Malpractice
0.08

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 95865 in Austin
ComponentRVULocality factorAdjusted
Physician work1.53× 1.0021.5331
Practice expense2.99× 1.0583.1634
Malpractice0.08× 0.8860.0709
Total RVUs4.7674
Conversion factor× 33.4009

Office / nonfacility rate, Austin$159.23

Open 95865 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.531.002
Practice expense2.991.058
Malpractice0.080.886

(1.53 × 1.002 + 2.99 × 1.058 + 0.08 × 0.886) × $33.4009 = $159.23

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

95865 · Office / nonfacility

$159.23

Effective 2026-10-01

The base rate is $14.30 higher than on 2025-10-01, moving from $144.93 to $159.23 (9.9%).

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

    $144.93changed to$159.23

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $144.93

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$159.23Not available in this settingRVU26D
2026-07-01$159.23Not available in this settingRVU26C
2026-04-01$159.23Not available in this settingRVU26B
2026-01-01$159.23Not available in this settingRVU26A
2025-10-01$144.93Not available in this settingRVU25D
2025-07-01$144.93Not available in this settingRVU25C
2025-04-01$144.93Not available in this settingRVU25B
2025-01-01$144.93Not available in this settingRVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 95865PPRRVU2026_Oct_nonQPP.csv, line 12,588 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet