CPT code 95869: Needle EMG, thoracic paraspinal muscles2026 Medicare rate & RVUs in West Virginia
Reports needle EMG sampling of thoracic paraspinal muscles when evaluating suspected thoracic nerve-root or related neuromuscular abnormalities.
In West Virginia, Medicare pays $84.86 for 95869 in the office.
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.
On this page 11 sections
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 West Virginia 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. West Virginia pays $84.86. The RVUs are the same everywhere; the geographic indexes change the dollars.
- West Virginia · this page$84.86
- Los Angeles, CA · California$110.39+$25.53
- Washington, DC area · District of Columbia$110.58+$25.72
- Miami, FL · Florida$100.09+$15.23
- Chicago, IL · Illinois$96.99+$12.13
- Manhattan, NY · New York$109.86+$25.00
- Alaska · Alaska$106.10+$21.24
Other areas in West Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $84.49 | — |
| 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 | — |
| Merced, CACalifornia | $102.82 | — |
| Modesto, CACalifornia | $102.82 | — |
| Napa, CACalifornia | $121.59 | — |
| Oxnard, CACalifornia | $110.11 | — |
| Redding, CACalifornia | $102.82 | — |
| Rest of CaliforniaCalifornia | $102.82 | — |
| Riverside, CACalifornia | $103.15 | — |
| Sacramento, CACalifornia | $108.55 | — |
| Salinas, CACalifornia | $108.16 | — |
| San Diego, CACalifornia | $111.20 | — |
| Marin County, CACalifornia | $129.48 | — |
| San Francisco, CACalifornia | $129.45 | — |
| San Benito County, CACalifornia | $132.37 | — |
| Santa Clara County, CACalifornia | $132.23 | — |
| San Luis Obispo, CACalifornia | $106.35 | — |
| Santa Cruz, CACalifornia | $112.65 | — |
| Santa Maria, CACalifornia | $108.70 | — |
| Santa Rosa, CACalifornia | $113.82 | — |
| Stockton, CACalifornia | $102.82 | — |
| Vallejo, CACalifornia | $121.54 | — |
| Visalia, CACalifornia | $102.82 | — |
| Yuba City, CACalifornia | $102.82 | — |
| ColoradoColorado | $100.38 | — |
| ConnecticutConnecticut | $101.97 | — |
| DelawareDelaware | $94.17 | — |
| Fort Lauderdale, FLFlorida | $97.07 | — |
| Rest of FloridaFlorida | $92.08 | — |
| Atlanta, GAGeorgia | $96.74 | — |
| Rest of GeorgiaGeorgia | $86.51 | — |
| Hawaii, Guam, HIHawaii | $106.03 | — |
| IowaIowa | $87.60 | — |
| IdahoIdaho | $88.09 | — |
| East St. Louis, ILIllinois | $89.64 | — |
| Rest of IllinoisIllinois | $88.61 | — |
| Suburban Chicago, ILIllinois | $98.27 | — |
| IndianaIndiana | $88.68 | — |
| KansasKansas | $86.81 | — |
| KentuckyKentucky | $85.99 | — |
| New Orleans, LALouisiana | $90.48 | — |
| Rest of LouisianaLouisiana | $85.70 | — |
| Metropolitan Boston, MAMassachusetts | $111.52 | — |
| Rest of MassachusettsMassachusetts | $99.54 | — |
| Baltimore area, MDMaryland | $101.62 | — |
| Rest of MarylandMaryland | $96.22 | — |
| Rest of MaineMaine | $88.24 | — |
| Southern Maine, MEMaine | $94.08 | — |
| Detroit, MIMichigan | $93.00 | — |
| Rest of MichiganMichigan | $88.17 | — |
| MinnesotaMinnesota | $96.87 | — |
| Metropolitan Kansas City, MOMissouri | $90.16 | — |
| Metropolitan St. Louis, MOMissouri | $91.25 | — |
| Rest of MissouriMissouri | $83.83 | — |
| MississippiMississippi | $83.51 | — |
| MontanaMontana | $95.19 | — |
| North CarolinaNorth Carolina | $89.33 | — |
| North DakotaNorth Dakota | $94.60 | — |
| NebraskaNebraska | $88.24 | — |
| New HampshireNew Hampshire | $98.44 | — |
| Northern New JerseyNew Jersey | $109.16 | — |
| Rest of New JerseyNew Jersey | $103.33 | — |
| New MexicoNew Mexico | $88.57 | — |
| NevadaNevada | $95.11 | — |
| NYC suburbs and Long Island, NYNew York | $112.35 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $103.75 | — |
| Queens, NYNew York | $111.36 | — |
| Rest of New YorkNew York | $90.79 | — |
| OhioOhio | $88.05 | — |
| OklahomaOklahoma | $86.18 | — |
| Portland, OROregon | $104.25 | — |
| Rest of OregonOregon | $94.57 | — |
| Metropolitan Philadelphia, PAPennsylvania | $98.97 | — |
| Rest of PennsylvaniaPennsylvania | $88.40 | — |
| Puerto RicoPuerto Rico | $96.08 | — |
| Rhode IslandRhode Island | $98.02 | — |
| South CarolinaSouth Carolina | $88.80 | — |
| South DakotaSouth Dakota | $94.53 | — |
| TennesseeTennessee | $87.25 | — |
| Austin, TXTexas | $99.87 | — |
| Beaumont, TXTexas | $87.73 | — |
| Brazoria, TXTexas | $94.33 | — |
| Dallas, TXTexas | $94.83 | — |
| Fort Worth, TXTexas | $94.02 | — |
| Galveston, TXTexas | $94.54 | — |
| Houston, TXTexas | $95.09 | — |
| Rest of TexasTexas | $90.90 | — |
| UtahUtah | $90.16 | — |
| VirginiaVirginia | $93.50 | — |
| Virgin Islands, VIUnited States Virgin Islands | $96.08 | — |
| VermontVermont | $93.88 | — |
| Rest of WashingtonWashington | $99.46 | — |
| King County, WAWashington | $114.26 | — |
| WisconsinWisconsin | $91.05 | — |
| WyomingWyoming | $94.93 | — |
95869 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $106.10 | 1 |
| AL | $84.49 | 1 |
| AR | $83.12 | 1 |
| AZ | $92.50 | 1 |
| CA | $102.82–$132.37 | 29 |
| CO | $100.38 | 1 |
| CT | $101.97 | 1 |
| DC | $110.58 | 1 |
| DE | $94.17 | 1 |
| FL | $92.08–$100.09 | 3 |
| GA | $86.51–$96.74 | 2 |
| GU | $106.03 | 1 |
| HI | $106.03 | 1 |
| IA | $87.60 | 1 |
| ID | $88.09 | 1 |
| IL | $88.61–$98.27 | 4 |
| IN | $88.68 | 1 |
| KS | $86.81 | 1 |
| KY | $85.99 | 1 |
| LA | $85.70–$90.48 | 2 |
| MA | $99.54–$111.52 | 2 |
| MD | $96.22–$110.58 | 3 |
| ME | $88.24–$94.08 | 2 |
| MI | $88.17–$93.00 | 2 |
| MN | $96.87 | 1 |
| MO | $83.83–$91.25 | 3 |
| MS | $83.51 | 1 |
| MT | $95.19 | 1 |
| NC | $89.33 | 1 |
| ND | $94.60 | 1 |
| NE | $88.24 | 1 |
| NH | $98.44 | 1 |
| NJ | $103.33–$109.16 | 2 |
| NM | $88.57 | 1 |
| NV | $95.11 | 1 |
| NY | $90.79–$112.35 | 5 |
| OH | $88.05 | 1 |
| OK | $86.18 | 1 |
| OR | $94.57–$104.25 | 2 |
| PA | $88.40–$98.97 | 2 |
| PR | $96.08 | 1 |
| RI | $98.02 | 1 |
| SC | $88.80 | 1 |
| SD | $94.53 | 1 |
| TN | $87.25 | 1 |
| TX | $87.73–$99.87 | 8 |
| UT | $90.16 | 1 |
| VA | $93.50–$110.58 | 2 |
| VI | $96.08 | 1 |
| VT | $93.88 | 1 |
| WA | $99.46–$114.26 | 2 |
| WI | $91.05 | 1 |
| WV | $84.86 | 1 |
| WY | $94.93 | 1 |
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
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 West Virginia 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
110
- Locality
- West Virginia
- Physician work
- 1.000
- Practice expense
- 0.869
- Malpractice
- 1.431
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.36 | × 1.000 | 0.3600 |
| Practice expense | 2.46 | × 0.869 | 2.1377 |
| Malpractice | 0.03 | × 1.431 | 0.0429 |
| Total RVUs | 2.5407 | ||
| Conversion factor | × 33.4009 | ||
Office rate, West Virginia$84.86
Office: (0.36 × 1 + 2.46 × 0.869 + 0.03 × 1.431) × $33.4009 = $84.86
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
| 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
95869 without 26 · national office
$95.19
Needle EMG, thoracic paraspinal muscles
95869-26 · Professional component
$19.71
Pays only the interpretation and report.
How 95869 has changed in West Virginia
95869 · Office / nonfacility
$84.86
Effective 2026-10-01
The base rate is $6.91 higher than on 2025-10-01, moving from $77.95 to $84.86 (8.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$77.95changed to$84.86
- 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
- Practice expense GPCI 0.862 changed to 0.869
- Malpractice GPCI 1.333 changed to 1.431
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$83.95changed to$77.95
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.45 changed to 2.32
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$82.58changed to$83.95
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$85.81changed to$82.58
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.47 changed to 2.45
- Practice expense GPCI 0.860 changed to 0.862
- Malpractice GPCI 1.266 changed to 1.333
January 1, 2023
RVU23A
$90.36changed to$85.81
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.57 changed to 2.47
- Practice expense GPCI 0.858 changed to 0.860
- Malpractice GPCI 1.198 changed to 1.266
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$92.00changed to$90.36
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.60 changed to 2.57
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$86.15changed to$92.00
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.31 changed to 2.60
- Practice expense GPCI 0.857 changed to 0.858
- Malpractice GPCI 1.247 changed to 1.198
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$84.85changed to$86.15
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.27 changed to 2.31
- Malpractice GPCI 1.296 changed to 1.247
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$84.44changed to$84.85
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.26 changed to 2.27
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$81.24changed to$84.44
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.19 changed to 2.26
- Practice expense GPCI 0.847 changed to 0.857
- Malpractice GPCI 1.289 changed to 1.296
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$81.37changed to$81.24
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.23 changed to 2.19
- Practice expense GPCI 0.836 changed to 0.847
- Malpractice GPCI 1.282 changed to 1.289
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$71.75changed to$81.37
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.90 changed to 2.23
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$71.40changed to$71.75
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$65.42changed to$71.40
- 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
- Practice expense GPCI 0.832 changed to 0.836
- Malpractice GPCI 1.256 changed to 1.282
Held through RVU15B.
January 1, 2014
RVU14A
$74.56changed to$65.42
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 2.17 changed to 1.72
- Practice expense GPCI 0.828 changed to 0.832
- Malpractice GPCI 1.229 changed to 1.256
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $74.56
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $84.86 | Not available in this setting | RVU26D |
| 2026-07-01 | $84.86 | Not available in this setting | RVU26C |
| 2026-04-01 | $84.86 | Not available in this setting | RVU26B |
| 2026-01-01 | $84.86 | Not available in this setting | RVU26A |
| 2025-10-01 | $77.95 | Not available in this setting | RVU25D |
| 2025-07-01 | $77.95 | Not available in this setting | RVU25C |
| 2025-04-01 | $77.95 | Not available in this setting | RVU25B |
| 2025-01-01 | $77.95 | Not available in this setting | RVU25A |
| 2024-10-01 | $83.95 | Not available in this setting | RVU24D |
| 2024-07-01 | $83.95 | Not available in this setting | RVU24C |
| 2024-04-01 | $83.95 | Not available in this setting | RVU24B |
| 2024-03-09 | $83.95 | Not available in this setting | RVU24AR |
| 2024-01-01 | $82.58 | Not available in this setting | RVU24A |
| 2023-10-01 | $85.81 | Not available in this setting | RVU23D |
| 2023-07-01 | $85.81 | Not available in this setting | RVU23C |
| 2023-04-01 | $85.81 | Not available in this setting | RVU23B |
| 2023-01-01 | $85.81 | Not available in this setting | RVU23A |
| 2022-10-01 | $90.36 | Not available in this setting | RVU22D |
| 2022-07-01 | $90.36 | Not available in this setting | RVU22C |
| 2022-04-01 | $90.36 | Not available in this setting | RVU22B |
| 2022-01-01 | $90.36 | Not available in this setting | RVU22A |
| 2021-10-01 | $92.00 | Not available in this setting | RVU21D |
| 2021-07-01 | $92.00 | Not available in this setting | RVU21C |
| 2021-04-01 | $92.00 | Not available in this setting | RVU21B |
| 2021-01-01 | $92.00 | Not available in this setting | RVU21A |
| 2020-10-01 | $86.15 | Not available in this setting | RVU20D |
| 2020-07-01 | $86.15 | Not available in this setting | RVU20C |
| 2020-04-01 | $86.15 | Not available in this setting | RVU20B |
| 2020-01-01 | $86.15 | Not available in this setting | RVU20A |
| 2019-10-01 | $84.85 | Not available in this setting | RVU19D |
| 2019-07-01 | $84.85 | Not available in this setting | RVU19C |
| 2019-04-01 | $84.85 | Not available in this setting | RVU19B |
| 2019-01-01 | $84.85 | Not available in this setting | RVU19A |
| 2018-10-01 | $84.44 | Not available in this setting | RVU18D |
| 2018-07-01 | $84.44 | Not available in this setting | RVU18C |
| 2018-04-01 | $84.44 | Not available in this setting | RVU18B |
| 2018-01-01 | $84.44 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $81.24 | Not available in this setting | RVU17D |
| 2017-07-01 | $81.24 | Not available in this setting | RVU17C |
| 2017-04-01 | $81.24 | Not available in this setting | RVU17B |
| 2017-01-01 | $81.24 | Not available in this setting | RVU17A |
| 2016-10-01 | $81.37 | Not available in this setting | RVU16D |
| 2016-07-01 | $81.37 | Not available in this setting | RVU16C |
| 2016-04-01 | $81.37 | Not available in this setting | RVU16B |
| 2016-01-01 | $81.37 | Not available in this setting | RVU16A |
| 2015-10-01 | $71.75 | Not available in this setting | RVU15D |
| 2015-07-01 | $71.75 | Not available in this setting | RVU15C |
| 2015-04-01 | $71.40 | Not available in this setting | RVU15B |
| 2015-01-01 | $71.40 | Not available in this setting | RVU15A |
| 2014-10-01 | $65.42 | Not available in this setting | RVU14D |
| 2014-07-01 | $65.42 | Not available in this setting | RVU14C |
| 2014-04-01 | $65.42 | Not available in this setting | RVU14B |
| 2014-01-01 | $65.42 | Not available in this setting | RVU14A |
| 2013-10-01 | $74.56 | Not available in this setting | RVU13D |
| 2013-07-01 | $74.56 | Not available in this setting | RVU13C |
| 2013-04-01 | $74.56 | Not available in this setting | RVU13B |
| 2013-01-01 | $74.56 | Not available in this setting | RVU13AR |
Where the West Virginia rate applies
West Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 439 cities and communities in West Virginia. Some span more than one payment area; confirm with the service ZIP.
- Accoville
- Addison (Webster Springs)
- Adrian
- Albright
- Alderson
- Alum Creek
- Amherstdale
- Anawalt
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
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