CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 95865 RVU and Medicare Payment (2026)
Needle emg larynx — 1.53 work RVU, about $153.64 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 1.53
- PE RVU (non-facility)
- 2.99
- PE RVU (facility)
- 2.99
- MP RVU
- 0.08
- Office payment
- $153.64
- Facility payment
- $153.64
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 95865 in a non-facility setting with national GPCI: (1.53 + 2.99 + 0.08) × $33.4009 ≈ $153.64. The same code in a facility setting pays about $153.64 because facility PE RVU (2.99) replaces office PE RVU.
What changes by locality
GPCI moves 95865 non-facility payment from $138.27 to $202.17 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 95865?
1.53. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 95865 in 2026?
About $153.64 non-facility ($153.64 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (1.53) and malpractice RVU stay fixed; only practice expense changes (2.99 office vs 2.99 facility). That is the entire office-vs-facility payment gap.