Nerve conduction studies totaling nine or ten individual studies in a session, with the interpretation and report.
- Medicare
- $220.11
- Work RVU
- 2.44
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Referral question and any expansion of the study
- Each study listed by nerve, type, and side
- Values with reference ranges
- Total of nine or ten studies
- Limb temperature
- Interpretation and diagnosis
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 3 cited references ↓
At nine or ten studies, the code is 95911. It usually reflects a bilateral upper extremity exam that includes median and ulnar nerves on both sides, or a lower extremity exam extended to rule out a peripheral neuropathy behind leg symptoms.
Study counts at this level start to draw audits when the diagnosis is a single entrapment. If the physician added nerves because early results suggested something broader, like a generalized neuropathy in a diabetic patient, the report should say so plainly.
The rules do not change with the tier: one unit per session, the code picked by the total count, and needle EMG added per limb with 95885 or 95886. The interpreting physician's report needs every study listed so an auditor can count them.
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 (2.44) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (6.59) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 2.44 |
| Practice expense RVU | 4.05 |
| Malpractice RVU | 0.1 |
| Total RVU | 6.59 |
| Medicare national rate | $220.11 |
| 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 | $220.11 |
HOPD (APC 5723) Hospital outpatient department | $381.24 |
Common denial reasons
The recurring reasons claims for CPT 95911 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Count exceeds the contractor's limit for a single entrapment diagnosis
- Study list in the report does not add up to the billed tier
- More than one unit billed
- No reason documented for expanding the exam
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Why would 95911 be denied for carpal tunnel?
02Is 95911 billed per side?
03Can I add a diagnosis after testing to support the count?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures diabetes history, sensory loss pattern, and bilateral findings at the visit, which supports a broader nerve study when the lab expands it.
See how Mira captures CPT 95911 documentation