Billing code 95925: Evoked potentialMedicare rate & RVUs in Delaware
Reports short-latency sensory pathway testing from the upper limbs, recording evoked responses to assess conduction toward the central nervous system.
Medicare pays $149.94 for 95925 in the office in Delaware (Delaware). 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.
On this page 9 sections
What 95925 covers
This study electrically stimulates peripheral sensory nerves in the upper limbs and records the resulting responses along sensory pathways toward the central nervous system. Neurologists and other qualified neurodiagnostic professionals use it to evaluate suspected sensory pathway dysfunction, including in patients with possible spinal cord or central nervous system disease. Testing may take place in an office or facility with the equipment and trained staff needed to stimulate nerves and record responses.
Report the upper-limb study when that is the tested pathway, and retain documentation of the stimulation, recorded responses, interpretation, and report. The code is priced bilaterally, so modifier 50 does not increase payment. CMS recognizes separate professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no 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.
95925 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $149.94 | Unavailable |
How the 95925 rate is calculated
Each of 95925’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 · 95925
RVUs × geographic indexes × conversion factor
Work0.53
0.53 RVUs× 1.000 GPCI
Practice expense3.95
3.95 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
4.5400
Conversion factor
$33.4009
Medicare rate
$151.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95925
The CMS indicators that decide how 95925 is paid alongside other services.
CMS payment indicators · 95925
Evoked potential
| 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
95925 without 26 · national office
$151.64
Evoked potential
95925-26 · Professional component
$27.39
Pays only the interpretation and report.
95925 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95926Somatosensory testing
- Choose 95925 for upper-limb sensory pathways and 95926 for lower-limb sensory pathways.
- 95927Somatosensory testing
- 95927 covers short-latency sensory testing of the trunk or head, not the upper limbs.
- 95928Motor evoked potentials
- 95928 evaluates central motor evoked responses in the upper limbs; 95925 evaluates sensory pathway responses.
- 95938Sensory evoked potentials
- 95938 is associated with intraspinal SSEP monitoring, while 95925 describes diagnostic upper-limb SSEP testing.
95925 billing questions
How does this differ from 95926?
95925 is for short-latency somatosensory testing of the upper limbs. Code 95926 identifies the lower-limb study.
Should modifier 50 be added when both arms are tested?
No. CMS prices 95925 as bilateral, and modifier 50 does not increase payment.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation or modifier TC for the technical service. Report without either modifier for the global service.
What documentation supports the study?
Document the upper-limb sensory stimulation, recorded evoked responses, and the interpreting professional’s findings and report.
Is this the code for intraoperative sensory monitoring?
No. Code 95925 describes an upper-limb diagnostic study; code 95938 is associated with intraspinal somatosensory evoked potential monitoring.
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
Fee sheets
Put 95925 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →