Formal range of motion measurement with a written report, for each extremity other than the hand or for each section of the spine.
- Medicare
- $26.05
- Work RVU
- 0.16
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 4 cited references ↓
- Reason a formal measurement was needed beyond the routine exam (impairment rating, disability evaluation)
- Each joint or spinal segment measured, with instrument used
- Active and passive values in degrees, with comparison to the other side or normal
- Separate written report
- Number of extremities or trunk sections measured, matching units
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 4 cited references ↓
95851 covers range of motion measurement and a separate report, per extremity (hands excluded, they use 95852) or per trunk section. It is a formal test, done with a goniometer or inclinometer and written up on its own, not the quick motion check that is part of every orthopedic exam.
Payers treat routine ROM measurement as part of the E/M visit or the therapy evaluation, and NCCI edits pair 95851 against those services. It gets paid when it is a distinct service with its own report, such as a formal impairment rating for workers' compensation, a disability evaluation, or a detailed spine inclinometry study ordered for a specific reason.
When a physical therapist bills it under a plan of care, Medicare wants the GP modifier. When billed with an E/M on the same day, the payer will want to see a separate report and a reason the measurement went beyond the exam, and a distinct-service modifier such as 59 or XU only applies when that is true.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.16) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (0.78) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.16 |
| Practice expense RVU | 0.61 |
| Malpractice RVU | 0.01 |
| Total RVU | 0.78 |
| Medicare national rate | $26.05 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $26.05 |
Common denial reasons
The recurring reasons claims for CPT 95851 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Bundled into the E/M or therapy evaluation on the same date
- No separate report, only exam findings in the visit note
- Missing GP modifier when billed under a therapy plan of care
- Distinct-service modifier used without a truly separate service
- Hand measurements billed as 95851 instead of 95852
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 4 cited references ↓
01Can I bill 95851 with an office visit?
02Is 95851 billed per joint?
03What code is used for hand range of motion?
04Does 95851 need the GP modifier?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records joint and spinal motion values in degrees by side during the exam, so the visit note shows exactly what was measured and how it compares.
See how Mira captures CPT 95851 documentation