Testing of autonomic nerve function focused on sweat gland (sudomotor) response, using methods such as quantitative sweat testing, with recording.
- Medicare
- $122.58
- Work RVU
- 0.88
- 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 ↓
- Clinical question, such as suspected CRPS or small fiber neuropathy
- Testing method used and sites tested
- Results compared with normal values
- Medications that could affect sweating, and whether they were held
- Interpretation
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 ↓
This is the sudomotor autonomic test. It measures sweat response to show whether small autonomic nerve fibers are working. Common methods include quantitative sudomotor axon reflex testing and skin potential testing.
For an ortho or podiatry practice, two referrals come up. One is complex regional pain syndrome after a wrist fracture or foot surgery, where abnormal sweating supports the diagnosis. The other is small fiber neuropathy in diabetic feet, where standard nerve conductions can look normal even when the patient has burning pain.
This is usually performed in a neurology or specialized autonomic lab, not in the ortho office. Payers often require a documented reason that standard testing did not answer the question, and some limit coverage for small fiber neuropathy workups. Cardiovagal testing (95921) and adrenergic testing (95922) have their own codes, and 95924 covers the combined cardiovagal and adrenergic study with tilt. The lab should report exactly what it ran.
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 (0.88) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.67) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.88 |
| Practice expense RVU | 2.74 |
| Malpractice RVU | 0.05 |
| Total RVU | 3.67 |
| Medicare national rate | $122.58 |
| 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 | $122.58 |
HOPD (APC 5734) Hospital outpatient department | $135.93 |
Common denial reasons
The recurring reasons claims for CPT 95923 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- No documented reason that standard testing was insufficient
- Payer policy limits coverage for the diagnosis
- Test method or sites not documented in the report
- Diagnosis not specific enough to support testing
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is 95923 used to diagnose CRPS?
02Can an orthopedic practice bill 95923?
03Is QSART billed with 95923?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures skin color, temperature, swelling, and sweating changes noted at the exam, which supports an autonomic test order when CRPS is on the table.
See how Mira captures CPT 95923 documentation