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CPT code 95868: Needle EMG, bilateral cranial nerve muscles2026 Medicare rate & RVUs in Arizona

Reports needle EMG of cranial nerve–supplied muscles on both sides, such as when evaluating facial weakness or other suspected cranial nerve dysfunction.

CMS RVU26DEffective Oct 1, 2026One payment locality5.2K Medicare services in 2024

In Arizona, Medicare pays $126.22 for 95868 in the office.

$126.22Office (non-facility)
Not available in this settingHospital or facility
−2.4%vs the national office rate ($129.26)

Check a contract rate as a % of Medicare · 95868 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 95868 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Arizona
  2. What 95868 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 95868 covers

A clinician inserts a fine needle electrode into selected muscles supplied by cranial nerves and records electrical activity at rest and during activation. Neurologists and physiatrists commonly perform the study when evaluating problems such as facial weakness or suspected cranial nerve-related muscle dysfunction. The examination covers muscles on both sides; it is not limited to a single facial muscle or side.

Report this code when the documented needle examination involves bilateral cranial nerve–supplied muscles. The record should identify the muscles examined and support the clinical reason for the study. Medicare recognizes professional and technical components: use modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier when billing the global service. The code is priced as bilateral, so modifier 50 does not increase payment; do not report separate units simply to represent the two sides.

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 Arizona compares for 95868

Across 109 of 109 payment localities, the office rate for 95868 runs from $115.76 in Arkansas to $171.83 in San Benito County, CA. Arizona pays $126.22. The RVUs are the same everywhere; the geographic indexes change the dollars.

95868 in Arizona vs other payment areas
  1. Arizona · this page$126.22
  2. Los Angeles, CA · California$146.42+$20.20
  3. Washington, DC area · District of Columbia$147.38+$21.16
  4. Miami, FL · Florida$135.97+$9.75
  5. Chicago, IL · Illinois$132.57+$6.35
  6. Manhattan, NY · New York$147.29+$21.07
  7. Alaska · Alaska$153.34+$27.12

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

Every other payment area

95868 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$117.29—
ArkansasArkansas$115.76—
Bakersfield, CACalifornia$137.74—
Chico, CACalifornia$137.51—
El Centro, CACalifornia$137.52—
Fresno, CACalifornia$137.51—
Hanford, CACalifornia$137.51—
Madera, CACalifornia$137.51—

95868 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.

$115.76

$154.67

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

View every state and territory as a table
95868 office rate range by state
State / territoryOffice rate rangeLocalities
AK$153.341
AL$117.291
AR$115.761
AZ$126.221
CA$137.51–$171.8329
CO$134.971
CT$137.291
DC$147.381
DE$128.181
FL$126.36–$135.973
GA$120.05–$131.202
GU$140.591
HI$140.591
IA$120.501
ID$121.101
IL$122.66–$133.484
IN$121.751
KS$119.741
KY$119.231
LA$118.96–$124.292
MA$134.18–$147.852
MD$130.55–$147.383
ME$121.40–$127.722
MI$121.79–$127.532
MN$130.431
MO$116.95–$125.003
MS$116.391
MT$129.261
NC$122.591
ND$128.071
NE$121.171
NH$132.651
NJ$139.17–$146.032
NM$122.291
NV$129.021
NY$124.22–$150.235
OH$121.551
OK$119.311
OR$128.31–$139.222
PA$121.87–$133.982
PR$130.211
RI$132.711
SC$122.211
SD$127.931
TN$120.251
TX$121.12–$134.268
UT$123.731
VA$127.16–$147.382
VI$130.211
VT$127.381
WA$133.99–$150.982
WI$124.141
WV$118.491
WY$128.741

See 95868 in every payment locality

How the 95868 rate is calculated

Each of 95868’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 · 95868

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.15

1.15 RVUs× 1.000 GPCI

Practice expense2.66

2.66 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

3.8700

Conversion factor

$33.4009

Medicare rate

$129.26

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

The exact Arizona inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,597

Code
95868
Physician work
1.15
Practice expense
2.66
Malpractice
0.06

GPCI2026.csv

6

Locality
Arizona
Physician work
1.000
Practice expense
0.969
Malpractice
0.856
Office calculation for 95868 in Arizona
ComponentRVULocality factorAdjusted
Physician work1.15× 1.0001.1500
Practice expense2.66× 0.9692.5775
Malpractice0.06× 0.8560.0514
Total RVUs3.7789
Conversion factor× 33.4009

Office rate, Arizona$126.22

Office: (1.15 × 1 + 2.66 × 0.969 + 0.06 × 0.856) × $33.4009 = $126.22

Open 95868 in the RVU calculator

Payment rules and modifiers for 95868

The CMS indicators that decide how 95868 is paid alongside other services.

CMS payment indicators · 95868

Needle EMG, bilateral cranial nerve muscles

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)2Already bilateral by definition: paid once at 100%.
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

95868 without 26 · national office

$129.26

Needle EMG, bilateral cranial nerve muscles

95868-26 · Professional component

$61.79

Pays only the interpretation and report.

When to use modifier 26

Codes related to 95868

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

Codes related to 95868
CodeHow it relatesOffice range, Arizona
Same family
95867Needle EMG, cranial nerve muscles, one sideUnilateral counterpart for needle EMG of cranial nerve–supplied muscles.$104.54
Used instead
95865Laryngeal EMG, needle studyUsed for needle EMG focused on laryngeal muscles.$150.16
95866Diaphragm EMG, one sideUsed for needle EMG of a hemidiaphragm.$133.13
95860Needle EMG, one extremityNeedle EMG code for one extremity rather than cranial nerve–supplied muscles.$116.65

How 95868 has changed in Arizona

95868 · Office / nonfacility

$126.22

Effective 2026-10-01

The base rate is $7.19 higher than on 2025-10-01, moving from $119.03 to $126.22 (6.0%).

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

    $119.03changed to$126.22

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.18 changed to 1.15
    • Practice expense RVU 2.52 changed to 2.66
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.975 changed to 0.969
    • Malpractice GPCI 0.854 changed to 0.856

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $135.43changed to$119.03

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.91 changed to 2.52
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $133.22changed to$135.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $137.05changed to$133.22

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.93 changed to 2.91
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.963 changed to 0.975
    • Malpractice GPCI 0.855 changed to 0.854

  5. January 1, 2023

    RVU23A

    $142.66changed to$137.05

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.04 changed to 2.93
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.951 changed to 0.963
    • Malpractice GPCI 0.857 changed to 0.855

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $144.18changed to$142.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.05 changed to 3.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $140.14changed to$144.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.76 changed to 3.05
    • Practice expense GPCI 0.961 changed to 0.951
    • Malpractice GPCI 0.846 changed to 0.857

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $138.41changed to$140.14

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.68 changed to 2.76
    • Malpractice RVU 0.07 changed to 0.06
    • Practice expense GPCI 0.971 changed to 0.961
    • Malpractice GPCI 0.834 changed to 0.846

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $135.47changed to$138.41

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.60 changed to 2.68

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $135.04changed to$135.47

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.55 changed to 2.60
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 0.986 changed to 0.971
    • Malpractice GPCI 0.856 changed to 0.834

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $133.91changed to$135.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.49 changed to 2.55
    • Practice expense GPCI 1.000 changed to 0.986
    • Malpractice GPCI 0.877 changed to 0.856

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $133.72changed to$133.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.48 changed to 2.49
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $133.06changed to$133.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $129.70changed to$133.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.42 changed to 2.48
    • Malpractice RVU 0.05 changed to 0.07
    • Practice expense GPCI 0.989 changed to 1.000
    • Malpractice GPCI 0.946 changed to 0.877

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $142.36changed to$129.70

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.02 changed to 2.42
    • Practice expense GPCI 0.978 changed to 0.989
    • Malpractice GPCI 1.015 changed to 0.946

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $142.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$126.22Not available in this settingRVU26D
2026-07-01$126.22Not available in this settingRVU26C
2026-04-01$126.22Not available in this settingRVU26B
2026-01-01$126.22Not available in this settingRVU26A
2025-10-01$119.03Not available in this settingRVU25D
2025-07-01$119.03Not available in this settingRVU25C
2025-04-01$119.03Not available in this settingRVU25B
2025-01-01$119.03Not available in this settingRVU25A
2024-10-01$135.43Not available in this settingRVU24D
2024-07-01$135.43Not available in this settingRVU24C
2024-04-01$135.43Not available in this settingRVU24B
2024-03-09$135.43Not available in this settingRVU24AR
2024-01-01$133.22Not available in this settingRVU24A
2023-10-01$137.05Not available in this settingRVU23D
2023-07-01$137.05Not available in this settingRVU23C
2023-04-01$137.05Not available in this settingRVU23B
2023-01-01$137.05Not available in this settingRVU23A
2022-10-01$142.66Not available in this settingRVU22D
2022-07-01$142.66Not available in this settingRVU22C
2022-04-01$142.66Not available in this settingRVU22B
2022-01-01$142.66Not available in this settingRVU22A
2021-10-01$144.18Not available in this settingRVU21D
2021-07-01$144.18Not available in this settingRVU21C
2021-04-01$144.18Not available in this settingRVU21B
2021-01-01$144.18Not available in this settingRVU21A
2020-10-01$140.14Not available in this settingRVU20D
2020-07-01$140.14Not available in this settingRVU20C
2020-04-01$140.14Not available in this settingRVU20B
2020-01-01$140.14Not available in this settingRVU20A
2019-10-01$138.41Not available in this settingRVU19D
2019-07-01$138.41Not available in this settingRVU19C
2019-04-01$138.41Not available in this settingRVU19B
2019-01-01$138.41Not available in this settingRVU19A
2018-10-01$135.47Not available in this settingRVU18D
2018-07-01$135.47Not available in this settingRVU18C
2018-04-01$135.47Not available in this settingRVU18B
2018-01-01$135.47Not available in this settingRVU18AR1
2017-10-01$135.04Not available in this settingRVU17D
2017-07-01$135.04Not available in this settingRVU17C
2017-04-01$135.04Not available in this settingRVU17B
2017-01-01$135.04Not available in this settingRVU17A
2016-10-01$133.91Not available in this settingRVU16D
2016-07-01$133.91Not available in this settingRVU16C
2016-04-01$133.91Not available in this settingRVU16B
2016-01-01$133.91Not available in this settingRVU16A
2015-10-01$133.72Not available in this settingRVU15D
2015-07-01$133.72Not available in this settingRVU15C
2015-04-01$133.06Not available in this settingRVU15B
2015-01-01$133.06Not available in this settingRVU15A
2014-10-01$129.70Not available in this settingRVU14D
2014-07-01$129.70Not available in this settingRVU14C
2014-04-01$129.70Not available in this settingRVU14B
2014-01-01$129.70Not available in this settingRVU14A
2013-10-01$142.36Not available in this settingRVU13D
2013-07-01$142.36Not available in this settingRVU13C
2013-04-01$142.36Not available in this settingRVU13B
2013-01-01$142.36Not available in this settingRVU13AR

Price 95868 for an earlier date of service

Where the Arizona rate applies

Arizona is a Medicare payment area, not a city. Our Census mapping connects it to 467 cities and communities in Arizona. Some span more than one payment area; confirm with the service ZIP.

  • Aguila
  • Ajo
  • Ak Chin
  • Ak-Chin Village
  • Alamo Lake
  • Ali Chuk
  • Ali Chukson
  • Ali Molina

Browse all communities in Arizona

95868 billing questions

How does this differ from 95867?

95868 represents examination of cranial nerve–supplied muscles on both sides. Use 95867 when the examination is unilateral.

Should modifier 50 be appended?

No. The code is already priced as bilateral, and modifier 50 does not increase payment.

When should modifier 26 or TC be used?

Use 26 for the professional interpretation and TC for the technical service, including equipment and staff. Bill without either modifier when reporting the global service.

What documentation supports reporting this code?

Document the cranial nerve–supplied muscles examined on both sides and the clinical indication, such as evaluation of facial weakness.

Is this the code for needle EMG of the larynx or diaphragm?

No. Code 95865 is for laryngeal needle EMG, and 95866 is for hemidiaphragm needle EMG; select based on the muscles examined.

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 95868PPRRVU2026_Oct_nonQPP.csv, line 12,597 (RVU26D)
Geographic factors for ArizonaGPCI2026.csv, line 6 (RVU26D)

Open CMS sourceHow we calculate rates

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