CPT code 95863: Needle EMG, three extremities2026 Medicare rate & RVUs in Michigan
Needle electromyography sampling three extremities evaluates muscle electrical activity to investigate conditions such as neuropathy, radiculopathy, or motor neuron disease.
Medicare pays $207.21–$217.03 for 95863 in the office in Michigan, from Rest of Michigan to Detroit, MI. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 95863 covers
Needle electromyography evaluates electrical activity in selected muscles in three extremities. A neurologist or physical medicine and rehabilitation physician commonly performs the study for suspected peripheral neuropathy, radiculopathy, plexopathy, motor neuron disease, or muscle disease. The clinician inserts a needle electrode into muscles and assesses findings such as spontaneous activity and motor-unit recruitment. Nerve conduction studies may be performed during the same diagnostic encounter.
Report this code when the needle examination covers three extremities; the selection is based on extremities studied, not the number of muscles sampled. Documentation should identify the clinical question, extremities and muscles examined, relevant findings, and the interpreting physician’s conclusions. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Reporting without either modifier represents the global service.
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.
Where 95863 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $217.03 | Unavailable |
| Rest of Michigan | $207.21 | Unavailable |
How the 95863 rate is calculated
Each of 95863’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 · 95863
RVUs × geographic indexes × conversion factor
Work1.82
1.82 RVUs× 1.000 GPCI
Practice expense4.69
4.69 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
6.6000
Conversion factor
$33.4009
Medicare rate
$220.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95863
The CMS indicators that decide how 95863 is paid alongside other services.
CMS payment indicators · 95863
Needle EMG, three extremities
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95863 without 26 · national office
$220.45
Needle EMG, three extremities
95863-26 · Professional component
$98.87
Pays only the interpretation and report.
95863 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95861Needle EMGTwo extremities
- Use 95861 when the needle examination covers two extremities. Use 95863 when it covers three.
- 95864Needle EMGFour extremities
- Use 95864 for a needle examination of four extremities; 95863 represents three.
- 95886Needle EMG add-onComplete study, each extremity
- Code 95886 describes a complete extremity EMG performed with nerve conduction testing. Code 95863 represents a three-extremity needle EMG, so select based on the service and reporting circumstances.
95863 billing questions
How is this code distinguished from the one- or two-extremity needle EMG codes?
Select the code according to the number of extremities examined by needle EMG. This code represents a study of three extremities, rather than one or two.
Does the number of muscles sampled determine the code?
No. The code level is based on the number of extremities studied, while the record should identify the muscles examined.
Can this be reported with nerve conduction studies?
Needle EMG and nerve conduction studies may be performed in the same diagnostic encounter. Document the distinct testing performed and report the applicable codes for the services provided.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
How does this differ from 95886?
This code identifies a needle EMG covering three extremities. Code 95886 is used for a complete extremity EMG performed in conjunction with nerve conduction testing, with its own unit and reporting rules.
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
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