Nerve conduction studies totaling thirteen or more individual studies in a single session, with interpretation and report.
- Medicare
- $299.94
- Work RVU
- 3.47
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Diagnosis supporting extensive testing
- Explanation of why testing expanded
- Every study labeled by nerve, type, and side
- Values with reference ranges
- Total count of thirteen or more
- Interpretation and conclusion
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 ↓
95913 is the top tier: thirteen or more studies. It is not reported in units, so a 20-study exam is still one unit of 95913.
Exams this large are uncommon from an orthopedic referral. They fit generalized neuropathy workups, suspected multifocal problems, or extensive trauma involving more than one limb. Many contractor maximum study tables set limits below thirteen for typical ortho diagnoses like carpal tunnel or lumbar radiculopathy, which makes 95913 a frequent target in reviews.
The report needs to show the reasoning: what was found early, and why additional nerves were tested. Needle EMG goes on with 95885 or 95886 per limb. Expect records requests on this code and keep the full waveform data available. A missing or incomplete waveform file is one of the fastest ways to lose this code on a post-payment review.
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 (3.47) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.98) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 3.47 |
| Practice expense RVU | 5.35 |
| Malpractice RVU | 0.16 |
| Total RVU | 8.98 |
| Medicare national rate | $299.94 |
| 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 | $299.94 |
HOPD (APC 5723) Hospital outpatient department | $381.24 |
Common denial reasons
The recurring reasons claims for CPT 95913 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Exceeds contractor study limits for the diagnosis
- Billed with more than one unit
- No explanation for expanding the study
- Waveform data unavailable on records request
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How do I bill 20 nerve conduction studies?
02Why is 95913 often audited?
03What should the report include for 95913?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records multi-limb symptoms and systemic history at the visit, giving an extensive nerve study a documented starting point.
See how Mira captures CPT 95913 documentation