Short-latency somatosensory evoked potential study with stimulation of peripheral nerves in the upper limbs and recording over the central nervous system.
- Medicare
- $151.64
- Work RVU
- 0.53
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Clinical indication, such as suspected cervical myelopathy
- Nerves stimulated and sides tested
- Recording sites and waveform latencies
- Comparison with normal values
- Interpretation of the sensory pathway
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 ↓
Upper limb SSEP, diagnostic. Peripheral nerves in the arms, usually the median or ulnar, are stimulated and the signal is recorded along the spinal cord and brain. It checks the sensory pathway through the cervical cord.
For a spine practice, the use case is cervical myelopathy, where a delayed or absent SSEP can support cord involvement when the exam and MRI are borderline. It also comes up as a preoperative baseline before cervical surgery.
Do not confuse this with intraoperative monitoring. During surgery, the monitoring provider reports the baseline SSEP plus the IONM time add-on codes, under a different set of rules from a diagnostic study. If both upper and lower limbs are tested in a diagnostic study, use 95938 instead of billing 95925 and 95926 together.
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 (0.53) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (4.54) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.53 |
| Practice expense RVU | 3.95 |
| Malpractice RVU | 0.06 |
| Total RVU | 4.54 |
| Medicare national rate | $151.64 |
| 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 | $151.64 |
HOPD (APC 5722) Hospital outpatient department | $220.60 |
Common denial reasons
The recurring reasons claims for CPT 95925 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 95926 instead of using 95938
- Diagnosis does not suggest central sensory pathway disease
- Billed for intraoperative monitoring without the correct IONM codes
- Duplicate testing without a change in condition
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Can 95925 and 95926 be billed together?
02Is 95925 used for intraoperative monitoring?
03What diagnoses support an upper limb SSEP?
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 documents gait, hand dexterity, reflexes, and Hoffmann sign findings, giving an SSEP order a clear clinical basis in suspected myelopathy.
See how Mira captures CPT 95925 documentation