FeeBase
Log inGet started
Menu

CPT code 51784: Sphincter EMG, nonneedle technique2026 Medicare rate & RVUs in Puerto Rico

Nonneedle electromyography records anal or urinary sphincter muscle activity, commonly during evaluation of urinary incontinence, voiding dysfunction, or pelvic floor coordination.

CMS RVU26DEffective Oct 1, 2026One payment locality131.3K Medicare services in 2024

In Puerto Rico, Medicare pays $66.86 for 51784 in the office.

$66.86Office (non-facility)
Not available in this settingHospital or facility
+0.6%vs the national office rate ($66.47)

Check a contract rate as a % of Medicare · 51784 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 51784 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 51784 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 51784 covers

This test records electrical activity from the anal or urinary sphincter muscles without needle electrodes. In urology and urogynecology practices, a clinician or trained staff member typically places surface electrodes near the perineum or anal sphincter and records muscle activity during rest, contraction, or voiding. It can help assess sphincter coordination in patients with urinary incontinence, difficulty emptying the bladder, or suspected pelvic floor dysfunction, often as part of a broader urodynamic evaluation.

Report the study when nonneedle sphincter electromyography is performed; use the needle-study code when needle electrodes are used. Documentation should identify the muscle area studied, the nonneedle technique, the test findings, and the interpretation. CMS allows billing for the professional interpretation with modifier 26, the equipment and staff portion with modifier TC, or the global service without either modifier. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple procedure reduction.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 51784

Across 109 of 109 payment localities, the office rate for 51784 runs from $59.61 in Arkansas to $85.33 in San Benito County, CA. Puerto Rico pays $66.86. The RVUs are the same everywhere; the geographic indexes change the dollars.

51784 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$66.86
  2. Los Angeles, CA · California$73.78+$6.92
  3. Washington, DC area · District of Columbia$75.10+$8.24
  4. Miami, FL · Florida$72.17+$5.31
  5. Chicago, IL · Illinois$70.30+$3.44
  6. Manhattan, NY · New York$75.98+$9.12
  7. Alaska · Alaska$80.02+$13.16

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

51784 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$60.38—
ArkansasArkansas$59.61—
ArizonaArizona$64.86—
Bakersfield, CACalifornia$69.67—
Chico, CACalifornia$69.43—
El Centro, CACalifornia$69.44—
Fresno, CACalifornia$69.43—
Hanford, CACalifornia$69.43—

51784 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$59.61

$80.02

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
51784 office rate range by state
State / territoryOffice rate rangeLocalities
AK$80.021
AL$60.381
AR$59.611
AZ$64.861
CA$69.43–$85.3329
CO$68.701
CT$70.551
DC$75.101
DE$65.851
FL$66.08–$72.173
GA$62.72–$67.712
GU$70.741
HI$70.741
IA$61.511
ID$61.911
IL$64.54–$70.304
IN$62.221
KS$61.361
KY$61.871
LA$61.82–$64.512
MA$68.40–$74.822
MD$66.97–$75.103
ME$62.30–$65.132
MI$63.38–$66.922
MN$65.731
MO$60.96–$64.583
MS$60.291
MT$66.461
NC$62.861
ND$64.881
NE$61.771
NH$67.751
NJ$71.33–$74.492
NM$63.731
NV$66.061
NY$63.70–$77.775
OH$63.061
OK$61.651
OR$65.52–$70.552
PA$63.09–$69.042
PR$66.861
RI$67.941
SC$63.071
SD$64.691
TN$61.641
TX$62.73–$68.508
UT$63.831
VA$65.01–$75.102
VI$66.861
VT$64.751
WA$68.24–$76.142
WI$62.961
WV$62.461
WY$65.771

See 51784 in every payment locality

How the 51784 rate is calculated

Each of 51784’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 51784

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense1.18

1.18 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

1.9900

Conversion factor

$33.4009

Medicare rate

$66.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

6,075

Code
51784
Physician work
0.73
Practice expense
1.18
Malpractice
0.08

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 51784 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense1.18× 1.0111.1930
Malpractice0.08× 0.9850.0788
Total RVUs2.0018
Conversion factor× 33.4009

Office rate, Puerto Rico$66.86

Office: (0.73 × 1 + 1.18 × 1.011 + 0.08 × 0.985) × $33.4009 = $66.86

Open 51784 in the RVU calculator

Payment rules and modifiers for 51784

The CMS indicators that decide how 51784 is paid alongside other services.

CMS payment indicators · 51784

Sphincter EMG, nonneedle technique

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

51784 without 26 · national office

$66.47

Sphincter EMG, nonneedle technique

51784-26 · Professional component

$37.07

Pays only the interpretation and report.

When to use modifier 26

Codes related to 51784

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 51784
CodeHow it relatesOffice range, Puerto Rico
Same family
51785Sphincter EMG, needle electrode techniqueNeedle-electrode sphincter electromyography; select it when the study uses needles.$395.79
Often billed with
51726Cystometrogram, electronic pressure-volume testingComplex cystometry may be performed during the same urodynamic evaluation.$273.10
51728Urodynamic study, with voiding pressureCystometry with voiding pressure measurements may accompany sphincter electromyography.$339.44
51741Uroflowmetry, complex electronic flow studyElectro-uroflowmetry may be included in the same voiding-function evaluation.$15.44

How 51784 has changed in Puerto Rico

51784 · Office / nonfacility

$66.86

Effective 2026-10-01

The base rate is $4.55 higher than on 2025-10-01, moving from $62.31 to $66.86 (7.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $62.31changed to$66.86

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 1.10 changed to 1.18
    • Malpractice RVU 0.07 changed to 0.08
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $64.45changed to$62.31

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $63.40changed to$64.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $64.97changed to$63.40

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.08 changed to 1.10
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $64.72changed to$64.97

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $66.00changed to$64.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.06 changed to 1.08
    • Malpractice RVU 0.09 changed to 0.08
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $67.62changed to$66.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.11 changed to 1.06
    • Malpractice RVU 0.07 changed to 0.09

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $69.56changed to$67.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.08 changed to 1.11
    • Malpractice RVU 0.09 changed to 0.07
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $69.81changed to$69.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.11 changed to 1.08
    • Malpractice RVU 0.07 changed to 0.09
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $71.55changed to$69.81

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.16 changed to 1.11

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $63.86changed to$71.55

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.15 changed to 1.16
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $151.26changed to$63.86

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.53 changed to 0.75
    • Practice expense RVU 3.76 changed to 1.15
    • Malpractice RVU 0.15 changed to 0.07
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $151.81changed to$151.26

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $151.05changed to$151.81

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $147.94changed to$151.05

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.71 changed to 3.76
    • Malpractice RVU 0.12 changed to 0.15
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $146.81changed to$147.94

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.06 changed to 3.71
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $146.81

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$66.86Not available in this settingRVU26D
2026-07-01$66.86Not available in this settingRVU26C
2026-04-01$66.86Not available in this settingRVU26B
2026-01-01$66.86Not available in this settingRVU26A
2025-10-01$62.31Not available in this settingRVU25D
2025-07-01$62.31Not available in this settingRVU25C
2025-04-01$62.31Not available in this settingRVU25B
2025-01-01$62.31Not available in this settingRVU25A
2024-10-01$64.45Not available in this settingRVU24D
2024-07-01$64.45Not available in this settingRVU24C
2024-04-01$64.45Not available in this settingRVU24B
2024-03-09$64.45Not available in this settingRVU24AR
2024-01-01$63.40Not available in this settingRVU24A
2023-10-01$64.97Not available in this settingRVU23D
2023-07-01$64.72Not available in this settingRVU23C
2023-04-01$64.72Not available in this settingRVU23B
2023-01-01$64.72Not available in this settingRVU23A
2022-10-01$66.00Not available in this settingRVU22D
2022-07-01$66.00Not available in this settingRVU22C
2022-04-01$66.00Not available in this settingRVU22B
2022-01-01$66.00Not available in this settingRVU22A
2021-10-01$67.62Not available in this settingRVU21D
2021-07-01$67.62Not available in this settingRVU21C
2021-04-01$67.62Not available in this settingRVU21B
2021-01-01$67.62Not available in this settingRVU21A
2020-10-01$69.56Not available in this settingRVU20D
2020-07-01$69.56Not available in this settingRVU20C
2020-04-01$69.56Not available in this settingRVU20B
2020-01-01$69.56Not available in this settingRVU20A
2019-10-01$69.81Not available in this settingRVU19D
2019-07-01$69.81Not available in this settingRVU19C
2019-04-01$69.81Not available in this settingRVU19B
2019-01-01$69.81Not available in this settingRVU19A
2018-10-01$71.55Not available in this settingRVU18D
2018-07-01$71.55Not available in this settingRVU18C
2018-04-01$71.55Not available in this settingRVU18B
2018-01-01$71.55Not available in this settingRVU18AR1
2017-10-01$63.86Not available in this settingRVU17D
2017-07-01$63.86Not available in this settingRVU17C
2017-04-01$63.86Not available in this settingRVU17B
2017-01-01$63.86Not available in this settingRVU17A
2016-10-01$151.26Not available in this settingRVU16D
2016-07-01$151.26Not available in this settingRVU16C
2016-04-01$151.26Not available in this settingRVU16B
2016-01-01$151.26Not available in this settingRVU16A
2015-10-01$151.81Not available in this settingRVU15D
2015-07-01$151.81Not available in this settingRVU15C
2015-04-01$151.05Not available in this settingRVU15B
2015-01-01$151.05Not available in this settingRVU15A
2014-10-01$147.94Not available in this settingRVU14D
2014-07-01$147.94Not available in this settingRVU14C
2014-04-01$147.94Not available in this settingRVU14B
2014-01-01$147.94Not available in this settingRVU14A
2013-10-01$146.81Not available in this settingRVU13D
2013-07-01$146.81Not available in this settingRVU13C
2013-04-01$146.81Not available in this settingRVU13B
2013-01-01$146.81Not available in this settingRVU13AR

Price 51784 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

51784 billing questions

How does this differ from 51785?

This code is for sphincter electromyography performed without needle electrodes. Use 51785 when the study uses needle electrodes.

Can this be reported with cystometry?

It is commonly performed as part of a urodynamic evaluation that also includes cystometry. Document the electromyography service separately, and apply the CMS multiple procedure reduction when multiple procedures are performed in the same session.

Which modifiers identify the professional and technical portions?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the equipment and staff portion. Report without either modifier for the global service.

What documentation supports reporting this study?

Record the sphincter area assessed, the nonneedle electrode technique, the patient's relevant activity during testing, and the findings and interpretation.

Does the multiple procedure reduction affect this code?

When it is performed with other procedures in the same session, CMS pays the highest-valued procedure in full and reduces the others to 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 51784PPRRVU2026_Oct_nonQPP.csv, line 6,075 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 51784 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 51784 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist