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CPT code 95869: Needle EMG, thoracic paraspinal muscles2026 Medicare rate & RVUs in Washington, DC area

Reports needle EMG sampling of thoracic paraspinal muscles when evaluating suspected thoracic nerve-root or related neuromuscular abnormalities.

CMS RVU26DEffective Oct 1, 2026One payment locality405 Medicare services in 2024

In Washington, DC area, Medicare pays $110.58 for 95869 in the office.

$110.58Office (non-facility)
Not available in this settingHospital or facility
+16.2%vs the national office rate ($95.19)

Check a contract rate as a % of Medicare · 95869 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 95869 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 95869 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 95869 covers

This service uses a needle electrode to record electrical activity in thoracic paraspinal muscles, including assessment for abnormal spontaneous activity or changes with muscle activation. Neurologists and physical medicine and rehabilitation physicians commonly perform it in an electrodiagnostic laboratory or office setting when symptoms or examination findings raise concern for a thoracic nerve-root or neuromuscular problem. The code is specific to thoracic paraspinals and excludes T1 and T12; it is not the code for limb muscles or other axial muscles.

Choose the code based on the muscles tested, not simply the patient’s symptoms. The report should identify the thoracic muscles and levels sampled, findings, and clinical question. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no modifier for the global service. The interpretation should support the professional component, while the technical record should support the testing resources billed.

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 Washington, DC area compares for 95869

Across 109 of 109 payment localities, the office rate for 95869 runs from $83.12 in Arkansas to $132.37 in San Benito County, CA. Washington, DC area pays $110.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

95869 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$110.58
  2. Los Angeles, CA · California$110.39−$0.19
  3. Miami, FL · Florida$100.09−$10.49
  4. Chicago, IL · Illinois$96.99−$13.59
  5. Manhattan, NY · New York$109.86−$0.72
  6. Alaska · Alaska$106.10−$4.48
  7. Alabama · Alabama$84.49−$26.09

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

95869 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$83.12—
ArizonaArizona$92.50—
Bakersfield, CACalifornia$102.92—
Chico, CACalifornia$102.82—
El Centro, CACalifornia$102.83—
Fresno, CACalifornia$102.82—
Hanford, CACalifornia$102.82—
Madera, CACalifornia$102.82—

95869 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.

$83.12

$117.60

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

View every state and territory as a table
95869 office rate range by state
State / territoryOffice rate rangeLocalities
AK$106.101
AL$84.491
AR$83.121
AZ$92.501
CA$102.82–$132.3729
CO$100.381
CT$101.971
DC$110.581
DE$94.171
FL$92.08–$100.093
GA$86.51–$96.742
GU$106.031
HI$106.031
IA$87.601
ID$88.091
IL$88.61–$98.274
IN$88.681
KS$86.811
KY$85.991
LA$85.70–$90.482
MA$99.54–$111.522
MD$96.22–$110.583
ME$88.24–$94.082
MI$88.17–$93.002
MN$96.871
MO$83.83–$91.253
MS$83.511
MT$95.191
NC$89.331
ND$94.601
NE$88.241
NH$98.441
NJ$103.33–$109.162
NM$88.571
NV$95.111
NY$90.79–$112.355
OH$88.051
OK$86.181
OR$94.57–$104.252
PA$88.40–$98.972
PR$96.081
RI$98.021
SC$88.801
SD$94.531
TN$87.251
TX$87.73–$99.878
UT$90.161
VA$93.50–$110.582
VI$96.081
VT$93.881
WA$99.46–$114.262
WI$91.051
WV$84.861
WY$94.931

See 95869 in every payment locality

How the 95869 rate is calculated

Each of 95869’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 · 95869

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.36

0.36 RVUs× 1.000 GPCI

Practice expense2.46

2.46 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

2.8500

Conversion factor

$33.4009

Medicare rate

$95.19

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,600

Code
95869
Physician work
0.36
Practice expense
2.46
Malpractice
0.03

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 95869 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.36× 1.0540.3794
Practice expense2.46× 1.1782.8979
Malpractice0.03× 1.1130.0334
Total RVUs3.3107
Conversion factor× 33.4009

Office rate, Washington, DC area$110.58

Office: (0.36 × 1.054 + 2.46 × 1.178 + 0.03 × 1.113) × $33.4009 = $110.58

Open 95869 in the RVU calculator

Payment rules and modifiers for 95869

The CMS indicators that decide how 95869 is paid alongside other services.

CMS payment indicators · 95869

Needle EMG, thoracic paraspinal muscles

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

95869 without 26 · national office

$95.19

Needle EMG, thoracic paraspinal muscles

95869-26 · Professional component

$19.71

Pays only the interpretation and report.

When to use modifier 26

Codes related to 95869

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

Codes related to 95869
CodeHow it relatesOffice range, Washington, DC area
Used instead
95870Needle EMG, limited muscle studyFor limited sampling of other axial or non-limb muscles rather than thoracic paraspinals.$100.35
95860Needle EMG, one extremityNeedle EMG code for testing one extremity instead of thoracic paraspinal muscles.$136.86
95861Needle EMG, two extremitiesNeedle EMG code for testing two extremities instead of thoracic paraspinal muscles.$184.44
95887Needle EMG, non-extremity, with nerve conductionCovers non-extremity muscle testing performed with nerve conduction testing.$100.95

How 95869 has changed in Washington, DC area

95869 · Office / nonfacility

$110.58

Effective 2026-10-01

The base rate is $7.34 higher than on 2025-10-01, moving from $103.24 to $110.58 (7.1%).

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

    $103.24changed to$110.58

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.37 changed to 0.36
    • Practice expense RVU 2.32 changed to 2.46
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $111.40changed to$103.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.45 changed to 2.32

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $109.58changed to$111.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $116.11changed to$109.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.47 changed to 2.45
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $124.77changed to$116.11

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.57 changed to 2.47
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $127.09changed to$124.77

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.60 changed to 2.57

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $117.18changed to$127.09

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.31 changed to 2.60
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $113.88changed to$117.18

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.27 changed to 2.31
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $113.32changed to$113.88

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.26 changed to 2.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $109.99changed to$113.32

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.19 changed to 2.26
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $111.51changed to$109.99

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.23 changed to 2.19
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $97.62changed to$111.51

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.90 changed to 2.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $97.14changed to$97.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $88.84changed to$97.14

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.72 changed to 1.90
    • Malpractice RVU 0.02 changed to 0.03
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $102.42changed to$88.84

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.17 changed to 1.72
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $102.42

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$110.58Not available in this settingRVU26D
2026-07-01$110.58Not available in this settingRVU26C
2026-04-01$110.58Not available in this settingRVU26B
2026-01-01$110.58Not available in this settingRVU26A
2025-10-01$103.24Not available in this settingRVU25D
2025-07-01$103.24Not available in this settingRVU25C
2025-04-01$103.24Not available in this settingRVU25B
2025-01-01$103.24Not available in this settingRVU25A
2024-10-01$111.40Not available in this settingRVU24D
2024-07-01$111.40Not available in this settingRVU24C
2024-04-01$111.40Not available in this settingRVU24B
2024-03-09$111.40Not available in this settingRVU24AR
2024-01-01$109.58Not available in this settingRVU24A
2023-10-01$116.11Not available in this settingRVU23D
2023-07-01$116.11Not available in this settingRVU23C
2023-04-01$116.11Not available in this settingRVU23B
2023-01-01$116.11Not available in this settingRVU23A
2022-10-01$124.77Not available in this settingRVU22D
2022-07-01$124.77Not available in this settingRVU22C
2022-04-01$124.77Not available in this settingRVU22B
2022-01-01$124.77Not available in this settingRVU22A
2021-10-01$127.09Not available in this settingRVU21D
2021-07-01$127.09Not available in this settingRVU21C
2021-04-01$127.09Not available in this settingRVU21B
2021-01-01$127.09Not available in this settingRVU21A
2020-10-01$117.18Not available in this settingRVU20D
2020-07-01$117.18Not available in this settingRVU20C
2020-04-01$117.18Not available in this settingRVU20B
2020-01-01$117.18Not available in this settingRVU20A
2019-10-01$113.88Not available in this settingRVU19D
2019-07-01$113.88Not available in this settingRVU19C
2019-04-01$113.88Not available in this settingRVU19B
2019-01-01$113.88Not available in this settingRVU19A
2018-10-01$113.32Not available in this settingRVU18D
2018-07-01$113.32Not available in this settingRVU18C
2018-04-01$113.32Not available in this settingRVU18B
2018-01-01$113.32Not available in this settingRVU18AR1
2017-10-01$109.99Not available in this settingRVU17D
2017-07-01$109.99Not available in this settingRVU17C
2017-04-01$109.99Not available in this settingRVU17B
2017-01-01$109.99Not available in this settingRVU17A
2016-10-01$111.51Not available in this settingRVU16D
2016-07-01$111.51Not available in this settingRVU16C
2016-04-01$111.51Not available in this settingRVU16B
2016-01-01$111.51Not available in this settingRVU16A
2015-10-01$97.62Not available in this settingRVU15D
2015-07-01$97.62Not available in this settingRVU15C
2015-04-01$97.14Not available in this settingRVU15B
2015-01-01$97.14Not available in this settingRVU15A
2014-10-01$88.84Not available in this settingRVU14D
2014-07-01$88.84Not available in this settingRVU14C
2014-04-01$88.84Not available in this settingRVU14B
2014-01-01$88.84Not available in this settingRVU14A
2013-10-01$102.42Not available in this settingRVU13D
2013-07-01$102.42Not available in this settingRVU13C
2013-04-01$102.42Not available in this settingRVU13B
2013-01-01$102.42Not available in this settingRVU13AR

Price 95869 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

95869 billing questions

When should 95869 be selected instead of 95870?

Use 95869 for thoracic paraspinal muscle testing. Code 95870 is for limited testing of other axial or non-limb muscles.

Does this code cover cervical or lumbar paraspinal muscles?

No. It describes thoracic paraspinal testing and excludes T1 and T12.

How are the professional and technical services billed?

Use modifier 26 for the interpretation and modifier TC for the equipment and staff. Reporting without a modifier represents the global service.

What documentation supports 95869?

Document the thoracic paraspinal muscles and levels sampled, the electrodiagnostic findings, and the clinical reason for testing.

Is 95869 the code for a limb needle EMG?

No. It is specific to thoracic paraspinal muscles; limb needle EMG codes are selected according to the extremity coverage.

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 95869PPRRVU2026_Oct_nonQPP.csv, line 12,600 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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