CPT 95913: Nerve Conduction Studies, 13+ Tests
Medicare pays $207 and commercial payers pay $309 on average nationally for this procedure.
CPT code 95913 describes a diagnostic nerve conduction study procedure involving 13 or more nerve conduction tests to evaluate motor and sensory nerve electrical function; the service is a neurophysiology diagnostic typically performed in an outpatient clinic or ambulatory electrodiagnostic lab setting to assess peripheral nerve disorders and guide clinical diagnosis.
For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.
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National Reimbursement Benchmarks
Medicare’s national mean of $207.20 sits noticeably below BUCA’s average commercial mean of $309.10, indicating a sizable gap of $101.90 between public and the BUCA commercial benchmark for CPT 95913. This gap highlights that commercial payers on average reimburse substantially more than Medicare for this code, with BUCA representing a higher average market position relative to the federal program.
Measuring dispersion by the interquartile range (P75−P25) highlights variation across payers: Blue Cross Blue Shield shows a tight spread of $139.20 (P75 $379.70 − P25 $240.50), while UnitedHealth Group and Cigna have wider spreads of $210.00 (UnitedHealth Group: $407.10 − $186.10) and $244.30 (Cigna: $390.90 − $164.60), respectively. Aetna’s spread is $161.10 and BUCA’s is $166.40; Medicare’s IQR is $167.50. Thus Cigna exhibits the widest dispersion and Blue Cross Blue Shield the tightest.