How much does Medicare pay for CPT 95865?

Medicare allowed an average of $80.31 per service and paid $63.77 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1051.43, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95865?

Needle measurement of electrical activity in voice box muscles. It was billed 1,106 times to 1,098 Medicare beneficiaries by 43 providers in 2024.

Which specialty bills 95865 most?

Neurology, with 979 services from 36 clinicians. Next are Physical Medicine and Rehabilitation, Pediatric Medicine, Audiologist.

CPT 95865

Needle measurement of electrical activity in voice box muscles

$80.31Medicare-allowed amount per service, averaged across 1,106 services

Providers submitted

$1051.43

Asking price, not received

Medicare allowed

$80.31

The fee schedule figure

Medicare paid

$63.77

Balance is patient coinsurance

Providers submitted an average of $1051.43 for this code and Medicare allowed $80.31 — 13.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $63.77 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,106
Beneficiaries: 1,098
Providers billing it: 43
Total allowed: $88,823

What Medicare pays for CPT 95865

Across 1,106 services billed by 43 providers to 1,098 beneficiaries, Medicare allowed an average of $80.31 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95865

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	979	971	$80.40	36
Physical Medicine and Rehabilitation	68	68	$78.58	3
Pediatric Medicine	18	18	$83.71	1
Audiologist	17	17	$78.49	1
General Practice	13	13	$83.84	1
General Surgery	11	11	$75.45	1

95865 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	193	$87.06	$62.61	9
Nevada	137	$80.62	$62.92	5
Pennsylvania	125	$82.17	$62.93	3
Arizona	93	$77.05	$62.86	3
Florida	82	$82.43	$62.99	3
Texas	82	$77.48	$62.97	2
Louisiana	80	$75.82	$62.89	1
Maryland	51	$73.73	$62.94	2
Michigan	44	$76.02	$63.16	1
Colorado	42	$82.61	$63.01	2
Georgia	25	$78.69	$60.46	2
Kansas	20	$75.63	$62.90	1
Ohio	20	$76.84	$63.00	1
North Carolina	17	$76.47	$62.98	1
Utah	17	$78.49	$63.10	1
Puerto Rico	16	$75.68	$63.16	1
Wisconsin	16	$76.76	$63.09	1
Minnesota	13	$78.54	$63.16	1
Washington	11	$80.03	$62.96	1
Tennessee	11	$75.45	$62.97	1
New York	11	$87.41	$62.60	1

Related codes

95886Needle measurement of electrical activity in arm or leg muscles$86.76
95816Measurement of brain wave activity (eeg)$227.96
95811Sleep study in sleep lab$314.61
95810Sleep study in sleep lab (6 years or older)$309.74
95800Sleep study including heart rate$117.17
95819Measurement of brain wave activity (eeg)$239.95
95885Needle measurement of electrical activity in arm or leg muscles$46.74
95806Sleep study including heart rate$54.06
95874Needle measurement of electrical activity in muscle$53.46
95861Needle measurement of electrical activity in arm or leg muscles$80.08
95870Needle measurement of electrical activity in arm$19.70
95813Measurement of brain wave activity (eeg)$202.49

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.