Billing code 95938: Sensory evoked potentialsMedicare rate & RVUs in Utah
Reports somatosensory evoked-potential testing of upper and lower limb pathways, often used to assess sensory conduction or monitor neural function during surgery.
Medicare pays $377.69 for 95938 in the office in Utah (Utah). 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 95938 covers
This study evaluates sensory pathways by stimulating peripheral nerves in the upper and lower limbs and recording evoked responses along the pathway, including at peripheral, spinal, and cortical sites. Neurologists or other qualified clinicians interpret the responses; trained technical staff may perform the stimulation and recording. The study may be performed in a diagnostic neurophysiology laboratory or during surgery when sensory pathway monitoring is needed.
Select this code when the testing covers both upper and lower limbs, rather than only one limb group or dermatomal stimulation. The report should identify the nerves or sites tested, the recorded responses, and the interpretation. Medicare recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier for 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.
95938 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $377.69 | Unavailable |
How the 95938 rate is calculated
Each of 95938’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 · 95938
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.84Practice expense 11.05Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95938
The CMS indicators that decide how 95938 is paid alongside other services.
CMS payment indicators · 95938
Sensory evoked potentials
| 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
95938 without 26 · national office
$400.14
Sensory evoked potentials
95938-26 · Professional component
$45.09
Pays only the interpretation and report.
95938 compared with similar codes
Compare codes
95938 vs 95925 vs 95926 vs 95927 vs 95939: national Medicare rates
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How to choose
- 95925Evoked potential
- 95925 covers upper-limb somatosensory testing; 95938 is used when both upper and lower limbs are tested.
- 95926Somatosensory testing
- 95926 covers lower-limb somatosensory testing; 95938 is used when testing includes both upper and lower limbs.
- 95927Somatosensory testing
- 95927 uses dermatomal stimulation. Choose 95938 for testing upper- and lower-limb sensory pathways through peripheral nerve stimulation.
- 95939Motor evoked potentials
- 95939 evaluates motor evoked potentials in upper and lower limbs. 95938 evaluates somatosensory pathways.
95938 billing questions
When should 95938 be chosen over 95925 or 95926?
Use 95938 for somatosensory evoked-potential testing that covers both upper and lower limbs. Codes 95925 and 95926 describe testing of upper limbs and lower limbs, respectively.
Does 95938 include bilateral testing?
Yes. CMS prices the code as bilateral; modifier 50 does not increase payment.
Which component modifier should be reported?
Report modifier 26 for the professional interpretation or modifier TC for the technical service. Report the global service without either modifier.
Is 95938 a sensory or motor evoked-potential study?
It is a somatosensory study of sensory pathways. Motor evoked-potential testing is distinct; 95939 covers upper- and lower-limb motor evoked potentials.
What documentation supports reporting 95938?
Document the upper- and lower-limb nerves or sites stimulated, the responses recorded, and the clinician's interpretation of the 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
Show the CMS file lines behind this rate
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