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95911

ActiveGlobal n/a

Nrv cndj test 9-10 studies

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.

Show values as
Component
Modifiers
LineQtyNon-facility (office)Facility (hospital/ASC)
959111$220.11$220.11
add-on95885
0
$64.46/ unit$64.46/ unit
add-on95886
0
$99.87/ unit$99.87/ unit
add-on95887
0
$88.18/ unit$88.18/ unit
add-on95940
0
$26.72/ unit$26.72/ unit
add-on95941
0
$0.00/ unit$0.00/ unit
add-onG0453
0
$27.39/ unit$27.39/ unit
Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF

RowWork RVUPE RVU (office)PE RVU (facility)MP RVUTotal (office)
959112.444.054.050.106.59
95911-262.441.441.440.093.97
95911-TC0.002.612.610.012.62

Payment policy for 95911

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=1

Diagnostic test

Has professional (-26) and technical (-TC) components, each priced separately.

Multiple procedures

mult_surg=0

No reduction

No multiple-procedure payment adjustment applies (typical for add-on codes).

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=0

Payable with documentation

Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.

Co-surgeons (modifier 62)

co_surg=0

Not permitted

Co-surgeons (mod 62) may not be paid for this procedure.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.

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