CPT code 95864: Needle EMG, four extremities2026 Medicare rate & RVUs in Texas
Reports needle electromyography sampling across all four extremities to evaluate suspected peripheral nerve, nerve root, motor neuron, or muscle disorders.
Medicare pays $224.73–$250.29 for 95864 in the office in Texas, from Beaumont, TX to Austin, TX. 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 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 Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$224.73 to $250.29
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $250.29 | Unavailable |
| Beaumont, TX | $224.73 | Unavailable |
| Brazoria, TX | $238.79 | Unavailable |
| Dallas, TX | $239.95 | Unavailable |
| Fort Worth, TX | $238.26 | Unavailable |
| Galveston, TX | $239.28 | Unavailable |
| Houston, TX | $240.93 | Unavailable |
| Rest of Texas | $231.39 | Unavailable |
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
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
| 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
95864 without 26 · national office
$240.49
Needle EMG, four extremities
95864-26 · Professional component
$104.88
Pays only the interpretation and report.
95864 compared with similar codes
Compare codes · National
4 codes, side by side
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
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