Needle electromyography of the laryngeal muscles, used to assess vocal fold movement problems and the nerves that control them.
- Medicare
- $153.64
- Work RVU
- 1.53
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Clinical reason, such as hoarseness or vocal fold paralysis after anterior cervical surgery
- Laryngoscopy findings that prompted the study
- Muscles tested and sides examined
- Needle findings including spontaneous activity and recruitment
- Interpretation addressing nerve injury and prognosis
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 2 cited references ↓
ENT or neurology usually performs laryngeal needle EMG, not orthopedics. It matters to a spine practice for one reason: anterior cervical surgery. Hoarseness after an ACDF can point to recurrent laryngeal nerve injury, and laryngeal EMG helps separate nerve injury from simple swelling or intubation trauma and gives a sense of recovery potential.
The spine surgeon typically refers rather than bills this code. If a postoperative patient is sent out within the 90-day global, the ENT or EMG provider bills 95865 under their own NPI; it is not part of the surgeon's global package.
CPT treats this as a bilateral study. When only one side is tested, append modifier 52. Do not use it for cranial nerve muscles outside the larynx, which belong to 95867 or 95868.
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 (1.53) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (4.6) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.53 |
| Practice expense RVU | 2.99 |
| Malpractice RVU | 0.08 |
| Total RVU | 4.6 |
| Medicare national rate | $153.64 |
| 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 | $153.64 |
HOPD (APC 5734) Hospital outpatient department | $135.93 |
Common denial reasons
The recurring reasons claims for CPT 95865 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Unilateral study billed without modifier 52
- No laryngoscopy or clinical findings supporting the test
- Diagnosis does not point to a laryngeal nerve problem
- Wrong code used for non-laryngeal cranial nerve muscles
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Is 95865 bilateral?
02Who bills laryngeal EMG after an ACDF?
03Is laryngeal EMG part of the surgical global period?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
Mira Scribe
Mira Scribe captures postoperative voice complaints and the referral reason at each follow-up visit, so the record shows when and why laryngeal testing was ordered.
See how Mira captures CPT 95865 documentation