Visual evoked potential testing of the central nervous system using a checkerboard or flash stimulus, with interpretation and report, not for glaucoma.
- Medicare
- $67.80
- Work RVU
- 0.34
- 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 suspected demyelinating disease
- Stimulus type
- Latency and amplitude results for each eye
- Normal values
- 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 2 cited references ↓
95930 measures the brain's response to a visual stimulus, usually a checkerboard pattern, to test the optic pathway. It is a neurology test, mainly used in demyelinating disease workups.
The orthopedic connection is indirect. When a patient referred for suspected cervical myelopathy has findings that do not fit the imaging, multiple sclerosis moves onto the differential, and neurology may order VEPs alongside SSEPs. The spine practice does not bill 95930, but it shows up in the shared record and can affect the surgical plan.
The code is not used for glaucoma screening, which has its own code. Billing errors usually involve diagnosis mismatch or using it as a routine screen. If the spine team requests it, the referral note should say what finding prompted the concern, such as visual symptoms or exam signs outside the expected level.
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 (0.34) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (2.03) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.34 |
| Practice expense RVU | 1.67 |
| Malpractice RVU | 0.02 |
| Total RVU | 2.03 |
| Medicare national rate | $67.80 |
| 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 | $67.80 |
HOPD (APC 5722) Hospital outpatient department | $220.60 |
Common denial reasons
The recurring reasons claims for CPT 95930 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Used for glaucoma evaluation
- No neurologic diagnosis supporting the study
- Routine screening without symptoms
- Billed by a provider who did not perform or interpret it
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Can 95930 be used for glaucoma?
02Why would a spine patient get a VEP?
03Does an orthopedic practice bill 95930?
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 records neurologic findings that do not fit a structural spine problem, which helps the team document why a neurology workup was requested.
See how Mira captures CPT 95930 documentation