Medicare rate for CPT 95913 in 2026

Medicare’s national 2026 allowed amount for CPT 95913 is $299.94 in a physician’s office, from the CMS 2026 October release. That is the doctor’s fee for the service when it is performed in a physician’s office. CMS marks the facility setting as not applicable for this code, so there is no separate hospital rate. The figure is a national amount before geographic adjustment. What a specific provider is actually paid depends on the Medicare locality they practice in.

Office (non-facility)$299.94The practice bears the overhead

Description: CMS’s short descriptor for a CPT code is AMA-licensed text and is not shown here · Status A: Active, payable · Source: CMS 2026 October (RVU26D, non-QP conversion factor), effective 10/2026.

How the $299.94 is built

Work RVU 3.47, practice-expense RVU 5.35 in an office, malpractice RVU 0.16. Each is multiplied by its geographic index, added together, then multiplied by the 2026 conversion factor of $33.4009. With every index at 1.000 that gives $299.94 in an office.

CMS marks the facility (hospital) setting as Not Applicable for 95913, so there is no separate hospital rate.

This is the allowed amount for one unit, before the 2% sequestration reduction and before any multiple-procedure reduction. It is what Medicare allows, not what a commercial carrier or an auto policy allows, and not what the provider billed. Current Procedural Terminology (CPT) is copyright 2019–2025 American Medical Association (AMA). All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. CPT® is a trademark of the American Medical Association.

Billed as a professional and technical split

When the scan and the read are done by different parties, CPT 95913 is billed twice: the technical component with modifier TC by whoever owns the equipment, and the professional component with modifier 26 by the physician who interprets it. The two add up to the global amount, so seeing all three on one bill for one study is a duplicate.

ComponentTotal RVUNational amount
Global8.98$299.94
Professional (-26)5.62$187.71
Technical (-TC)3.36$112.23

What CPT 95913 pays in New Jersey

New Jersey has 2 Medicare localities, so there is no single New Jersey rate. In an office the allowed amount runs from $321.53 to $336.20, a spread of 4.6% across the state.

LocalityOffice
Northern NJ$336.20
Rest Of New Jersey$321.53

CPT 95913 by fee-schedule year, 2023 to 2026

A bill is priced under the schedule in force on its date of service, not the one in force when it is reviewed. Note that 2024 has two entries: Congress changed the conversion factor on 9 March 2024, so a January 2024 date of service and a June 2024 date of service price differently.

Fee-schedule yearConversion factorOffice
2026$33.4009$299.94
2025$32.3465$274.95
2024 (Mar 9 to Dec 31)$33.2875$284.28
2024 (Jan 1 to Mar 8)$32.7442$279.64
2023$33.8872$288.38

National amounts, every geographic index at 1.000, so the year-to-year movement here is the fee schedule changing and not a change of location.

CPT 95913 in every state

The office allowed amount in each state, highest locality to lowest. Where a state shows one figure it has a single Medicare locality.

StateHighestLowestLocalities
California$389.19$316.5929
Alaska$367.11-1
New York$345.71$289.425
Washington$345.32$309.642
Massachusetts$338.77$310.182
District of Columbia$338.61-1
New Jersey$336.20$321.532
Hawaii / Guam$322.17-1
Oregon$320.26$297.642
Connecticut$317.14-1
Maryland$316.11$302.812
Florida$315.44$294.773
Colorado$311.60-1
Pennsylvania$310.38$284.992
Texas$309.93$283.488
Illinois$309.70$287.404
Rhode Island$307.46-1
New Hampshire$306.60-1
Georgia$304.22$281.672
Puerto Rico$301.83-1
Virgin Islands$301.83-1
Minnesota$301.36-1
Montana$299.93-1
Nevada$299.23-1
Wyoming$298.55-1
Delaware$297.84-1
Michigan$297.35$285.082
North Dakota$296.77-1
South Dakota$296.39-1
Maine$296.36$283.622
Vermont$295.51-1
Virginia$295.33-1
Arizona$293.63-1
Missouri$291.37$275.143
Louisiana$290.12$279.172
Wisconsin$288.74-1
Utah$288.67-1
New Mexico$286.18-1
North Carolina$286.04-1
South Carolina$285.56-1
Ohio$284.44-1
Indiana$284.15-1
Nebraska$282.86-1
Idaho$282.83-1
Iowa$281.53-1
Tennessee$281.20-1
Kansas$280.13-1
Kentucky$279.65-1
Oklahoma$279.63-1
West Virginia$278.83-1
Alabama$275.28-1
Mississippi$273.71-1
Arkansas$272.15-1

Checking a different code, state or year

The Medicare rate lookup prices all 17,000-plus codes in the Physician Fee Schedule for any state and any fee-schedule year from 2023 to 2026. Ambulance codes are priced separately on the ambulance fee schedule, because Medicare does not pay for ambulance transport under this schedule at all.

More in Nerve conduction and EMG

A single figure means the office and facility amounts are the same, or CMS prices the code in one setting only; the code’s own page says which. All 25 codes in this family, with their national amounts, are on the Nerve conduction and EMG page. See also the full list of code families and the CMS release catalog, which names the archived CMS files behind every figure.

Medicare rates are a benchmark, not an allowance. What a no-fault, workers’ compensation or commercial carrier owes for CPT 95913 is set by the fee schedule or policy that governs the claim, which is frequently a multiple of the figure above.

One code is one line of a bill.

Desk prices a whole case against the schedule that actually governs the claim, with every line cited to the document it came from. Fair Measure Billing Experts prepares and signs the report when you need someone else to write it.