CPT code 95864: Needle EMG, four extremities2026 Medicare rate & RVUs in California

Reports needle electromyography sampling across all four extremities to evaluate suspected peripheral nerve, nerve root, motor neuron, or muscle disorders.

CMS RVU26DEffective Oct 1, 202629 payment localities1.2K Medicare services in 2024

Medicare pays $256.77–$322.55 for 95864 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

$256.77–$322.55Office (non-facility)
—Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 95864 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 95864 covers

A clinician inserts a fine needle electrode into selected muscles in all four limbs and records electrical activity at rest and during muscle contraction. The findings help evaluate conditions such as radiculopathy, peripheral neuropathy, motor neuron disease, or myopathy. Neurologists and physical medicine and rehabilitation physicians commonly perform or interpret the study in outpatient electrodiagnostic laboratories and hospital settings; relevant paraspinal muscles may also be sampled when clinically indicated.

Choose this code when the needle examination covers all four extremities, rather than fewer limbs or a limited muscle sample. The report should identify the limbs and muscles examined, relevant findings, and the clinical question addressed. CMS recognizes a professional interpretation component and a technical component for equipment and staff: report modifier 26 for the professional component, modifier TC for the technical component, or neither modifier for 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 95864 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 payment localities

$256.77 to $322.55

$256.77$289.66$322.55
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

29 of 29 payment localities

95864 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CA$257.12Unavailable
Chico, CA$256.77Unavailable
El Centro, CA$256.79Unavailable
Fresno, CA$256.77Unavailable
Hanford, CA$256.77Unavailable
Los Angeles, CA$273.73Unavailable
Madera, CA$256.77Unavailable
Marin County, CA$315.82Unavailable
Merced, CA$256.77Unavailable
Modesto, CA$256.77Unavailable

How the 95864 rate is calculated

Each of 95864’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 · 95864

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.94

1.94 RVUs× 1.000 GPCI

Practice expense5.17

5.17 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

7.2000

Conversion factor

$33.4009

Medicare rate

$240.49

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

Payment rules and modifiers for 95864

The CMS indicators that decide how 95864 is paid alongside other services.

CMS payment indicators · 95864

Needle EMG, four extremities

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
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

95864 without 26 · national office

$240.49

Needle EMG, four extremities

95864-26 · Professional component

$104.88

Pays only the interpretation and report.

When to use modifier 26

95864 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 95864

    Needle EMG, four extremities1.94 wRVU

    $240.49

  • 95863

    Needle EMG, three extremities1.82 wRVU

    $220.45−$20.04

  • 95885

    Needle EMG, limited, with nerve conduction0.34 wRVU

    $64.46−$176.03

  • 95886

    Needle EMG add-on, complete study, each extremity0.84 wRVU

    $99.87−$140.62

How to choose

95863Needle EMGThree extremities
Choose 95863 when the needle examination covers three extremities; choose 95864 when it covers all four.
95885Needle EMGLimited, with nerve conduction
95885 describes a limited needle examination by extremity performed with nerve conduction testing, rather than the four-extremity study reported with 95864.
95886Needle EMG add-onComplete study, each extremity
95886 describes a complete needle examination by extremity performed with nerve conduction testing. Use 95864 for a four-extremity study outside that reporting circumstance.

95864 billing questions

When should 95864 be selected instead of 95863?

Use 95864 when the needle examination covers all four extremities. Code 95863 describes a study covering three extremities.

Does 95864 represent four units?

The code represents a needle EMG study of four extremities, not one unit for each limb. Document the limbs and muscles examined.

How are the professional and technical portions reported?

Use modifier 26 for the interpretation and modifier TC for the equipment and staff portion. Report without either modifier when billing the global service.

How does 95864 differ from 95886?

95864 covers needle examination of four extremities. Code 95886 is reported by extremity for a complete needle examination performed with nerve conduction testing.

What documentation supports 95864?

Record the clinical reason for testing, the extremities and muscles sampled, and the examination findings and interpretation. The documentation should support that the study covered all four extremities.

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 95864PPRRVU2026_Oct_nonQPP.csv, line 12,585 (RVU26D)

Open CMS sourceHow we calculate rates

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