Short-latency somatosensory evoked potential study stimulating peripheral nerves in both the upper and lower limbs, recorded over the central nervous system.
- Medicare
- $400.14
- Work RVU
- 0.84
- 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 or the surgical procedure being monitored
- Upper and lower limb nerves stimulated
- Recording sites and latencies
- Baseline values for comparison if intraoperative
- 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 ↓
95938 is the combined upper and lower limb SSEP. It replaces billing 95925 and 95926 together when all four limbs are tested in one session.
Spine surgeons see it in two settings. Diagnostically, it helps evaluate myelopathy when the level of cord involvement is unclear. In the OR, it is often reported for the baseline studies at the start of intraoperative neuromonitoring during cervical or thoracolumbar fusion, deformity correction, or tumor surgery, alongside the IONM time codes.
For IONM, the monitoring provider bills the baseline study and the monitoring time. The surgeon does not bill monitoring done by an outside team, and CPT does not allow the operating surgeon to report monitoring of their own case. Do not report 95938 with 95925 or 95926 for the same session.
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 (0.84) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.98) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.84 |
| Practice expense RVU | 11.05 |
| Malpractice RVU | 0.09 |
| Total RVU | 11.98 |
| Medicare national rate | $400.14 |
| 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 | $400.14 |
HOPD (APC 5724) Hospital outpatient department | $877.34 |
Common denial reasons
The recurring reasons claims for CPT 95938 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 95925 or 95926 on the same date
- Surgeon billed monitoring as part of their own procedure
- Diagnostic indication not documented
- Monitoring time codes billed without the required documentation
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Can 95938 be billed with 95925?
02Is 95938 used in intraoperative monitoring?
03Can the spine surgeon bill 95938 during surgery?
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 the neurologic exam and surgical plan before spine surgery, so the record supports a baseline evoked potential study when monitoring is planned.
See how Mira captures CPT 95938 documentation