CPT code 95867: Needle EMG, cranial nerve muscles, one side2026 Medicare rate & RVUs in Texas
Reports needle electromyography of muscles supplied by cranial nerves on one side, such as when evaluating facial weakness or suspected cranial motor nerve dysfunction.
Medicare pays $99.91–$111.77 for 95867 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 95867 covers
This study uses a fine needle electrode to record electrical activity in muscles supplied by cranial nerves on one side of the body. A neurologist or physiatrist commonly performs it to assess problems such as facial weakness or suspected cranial motor nerve dysfunction. The clinician samples appropriate muscles and evaluates their activity at rest and during voluntary contraction, then interprets the findings in the clinical context. It may be performed in an office or hospital setting.
Choose this code when the study evaluates cranial nerve-innervated muscles on one side; documentation should identify the side, muscles examined, clinical indication, findings, and interpretation. For bilateral cranial nerve muscle testing, use the bilateral code rather than reporting this unilateral service twice. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and billing without either modifier represents the combined 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 95867 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
$99.91 to $111.77
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $111.77 | Unavailable |
| Beaumont, TX | $99.91 | Unavailable |
| Brazoria, TX | $106.41 | Unavailable |
| Dallas, TX | $106.94 | Unavailable |
| Fort Worth, TX | $106.15 | Unavailable |
| Galveston, TX | $106.63 | Unavailable |
| Houston, TX | $107.36 | Unavailable |
| Rest of Texas | $103.00 | Unavailable |
How the 95867 rate is calculated
Each of 95867’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 · 95867
RVUs × geographic indexes × conversion factor
Work0.77
0.77 RVUs× 1.000 GPCI
Practice expense2.40
2.40 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
3.2100
Conversion factor
$33.4009
Medicare rate
$107.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95867
The CMS indicators that decide how 95867 is paid alongside other services.
CMS payment indicators · 95867
Needle EMG, cranial nerve muscles, one side
| 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
95867 without 26 · national office
$107.22
Needle EMG, cranial nerve muscles, one side
95867-26 · Professional component
$41.08
Pays only the interpretation and report.
95867 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95868Needle EMGBilateral cranial nerve muscles
- 95868 is for cranial nerve-innervated muscles on both sides. This code is for one side.
- 95865Laryngeal EMGNeedle study
- 95865 identifies needle EMG focused on laryngeal muscles. Use 95867 for other cranial nerve-innervated muscles tested unilaterally.
- 95870Needle EMGLimited muscle study
- 95870 describes a limited needle EMG study. Choose 95867 when the study is specifically of cranial nerve-innervated muscles on one side.
- 95885Needle EMGLimited, with nerve conduction
- 95885 describes limited extremity muscle testing performed with nerve conduction testing. It is not the code for unilateral cranial nerve muscle EMG.
95867 billing questions
When should 95867 be chosen over 95868?
Use 95867 when cranial nerve-innervated muscles are tested on one side. Use 95868 when the study covers both sides.
What should the report document?
Document the clinical reason for testing, the side and muscles examined, the needle EMG findings, and the interpretation.
How are the professional and technical portions reported?
Modifier 26 reports the professional interpretation, and modifier TC reports the technical portion, including equipment and staff. Without either modifier, the code represents the combined service.
Can 95867 be reported for laryngeal muscle testing?
Use 95865 for needle EMG focused on laryngeal muscles. Code 95867 is for cranial nerve-innervated muscles outside that site-specific service.
Is this code reported once for each muscle tested?
The code describes unilateral cranial nerve muscle testing, not a separate unit for each sampled muscle. Document the muscles examined and select the code according to the side or sides studied.
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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