CPT code 95870: Needle EMG, limited muscle study2026 Medicare rate & RVUs in Delaware

Reports a focused needle EMG sampling muscles in one extremity or axial muscles when the examination is limited rather than a broader extremity study.

CMS RVU26DEffective Oct 1, 2026One payment locality47.3K Medicare services in 2024

In Delaware, Medicare pays $85.59 for 95870 in the office.

$85.59Office (non-facility)
Not available in this settingHospital or facility
−1.1%vs the national office rate ($86.51)

Check a contract rate as a % of Medicare · 95870 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 95870 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 95870 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 95870 covers

A clinician inserts a fine needle electrode into selected muscles and evaluates their electrical activity at rest and during contraction. This limited examination may help assess a focused concern, such as localized weakness or suspected nerve-related muscle changes. Neurologists and physiatrists commonly perform needle EMG in an electrodiagnostic laboratory, outpatient clinic, or hospital setting. The muscles examined may be in one limb or in an axial area; the specific code for the service depends on the body region and scope of the examination.

Choose this code when the documented needle examination is limited, rather than a broader study of one or more extremities. The report should identify the muscles examined, the clinical question, and the findings supporting the interpretation. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The professional and technical components are separately priced when billed with their respective modifiers.

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 Delaware compares for 95870

Across 109 of 109 payment localities, the office rate for 95870 runs from $75.66 in Arkansas to $119.85 in San Benito County, CA. Delaware pays $85.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

95870 in Delaware vs other payment areas
  1. Delaware · this page$85.59
  2. Los Angeles, CA · California$100.11+$14.52
  3. Washington, DC area · District of Columbia$100.35+$14.76
  4. Miami, FL · Florida$91.05+$5.46
  5. Chicago, IL · Illinois$88.26+$2.67
  6. Manhattan, NY · New York$99.77+$14.18
  7. Alaska · Alaska$96.85+$11.26

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

Every other payment area

95870 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$76.89—
ArkansasArkansas$75.66—
ArizonaArizona$84.09—
Bakersfield, CACalifornia$93.40—
Chico, CACalifornia$93.30—
El Centro, CACalifornia$93.31—
Fresno, CACalifornia$93.30—
Hanford, CACalifornia$93.30—

95870 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.

$75.66

$106.57

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

View every state and territory as a table
95870 office rate range by state
State / territoryOffice rate rangeLocalities
AK$96.851
AL$76.891
AR$75.661
AZ$84.091
CA$93.30–$119.8529
CO$91.141
CT$92.621
DC$100.351
DE$85.591
FL$83.78–$91.053
GA$78.76–$87.922
GU$96.151
HI$96.151
IA$79.661
ID$80.101
IL$80.68–$89.354
IN$80.631
KS$78.961
KY$78.271
LA$78.02–$82.312
MA$90.39–$101.152
MD$87.43–$100.353
ME$80.25–$85.482
MI$80.24–$84.622
MN$87.931
MO$76.34–$82.983
MS$76.031
MT$86.511
NC$81.221
ND$85.911
NE$80.231
NH$89.401
NJ$93.85–$99.092
NM$80.611
NV$86.411
NY$82.54–$102.025
OH$80.121
OK$78.421
OR$85.92–$94.602
PA$80.43–$89.932
PR$87.301
RI$89.051
SC$80.771
SD$85.841
TN$79.361
TX$79.82–$90.688
UT$82.001
VA$84.96–$100.352
VI$87.301
VT$85.281
WA$90.32–$103.612
WI$82.731
WV$77.311
WY$86.251

See 95870 in every payment locality

How the 95870 rate is calculated

Each of 95870’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 · 95870

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.36

0.36 RVUs× 1.000 GPCI

Practice expense2.20

2.20 RVUs× 1.000 GPCI

Malpractice0.03

0.03 RVUs× 1.000 GPCI

Adjusted RVUs

2.5900

Conversion factor

$33.4009

Medicare rate

$86.51

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,603

Code
95870
Physician work
0.36
Practice expense
2.20
Malpractice
0.03

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 95870 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.36× 1.0050.3618
Practice expense2.20× 0.9882.1736
Malpractice0.03× 0.8990.0270
Total RVUs2.5624
Conversion factor× 33.4009

Office rate, Delaware$85.59

Office: (0.36 × 1.005 + 2.2 × 0.988 + 0.03 × 0.899) × $33.4009 = $85.59

Open 95870 in the RVU calculator

Payment rules and modifiers for 95870

The CMS indicators that decide how 95870 is paid alongside other services.

CMS payment indicators · 95870

Needle EMG, limited muscle study

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

95870 without 26 · national office

$86.51

Needle EMG, limited muscle study

95870-26 · Professional component

$19.71

Pays only the interpretation and report.

When to use modifier 26

How 95870 has changed in Delaware

95870 · Office / nonfacility

$85.59

Effective 2026-10-01

The base rate is $8.42 higher than on 2025-10-01, moving from $77.17 to $85.59 (10.9%).

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

    $77.17changed to$85.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.37 changed to 0.36
    • Practice expense RVU 2.00 changed to 2.20
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $82.39changed to$77.17

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.09 changed to 2.00

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $81.04changed to$82.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $84.90changed to$81.04

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949
  5. January 1, 2023

    RVU23A

    $90.58changed to$84.90

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 2.17 changed to 2.09
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $95.25changed to$90.58

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.28 changed to 2.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $94.13changed to$95.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 2.16 changed to 2.28
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $94.70changed to$94.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 2.18 changed to 2.16
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $98.99changed to$94.70

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.30 changed to 2.18

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $96.26changed to$98.99

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.22 changed to 2.30
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $96.89changed to$96.26

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 2.23 changed to 2.22
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $92.03changed to$96.89

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 2.10 changed to 2.23
    • Malpractice RVU 0.02 changed to 0.03

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $91.57changed to$92.03

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $91.01changed to$91.57

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.07 changed to 2.10
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $94.89changed to$91.01

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.30 changed to 2.07
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $94.89

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$85.59Not available in this settingRVU26D
2026-07-01$85.59Not available in this settingRVU26C
2026-04-01$85.59Not available in this settingRVU26B
2026-01-01$85.59Not available in this settingRVU26A
2025-10-01$77.17Not available in this settingRVU25D
2025-07-01$77.17Not available in this settingRVU25C
2025-04-01$77.17Not available in this settingRVU25B
2025-01-01$77.17Not available in this settingRVU25A
2024-10-01$82.39Not available in this settingRVU24D
2024-07-01$82.39Not available in this settingRVU24C
2024-04-01$82.39Not available in this settingRVU24B
2024-03-09$82.39Not available in this settingRVU24AR
2024-01-01$81.04Not available in this settingRVU24A
2023-10-01$84.90Not available in this settingRVU23D
2023-07-01$84.90Not available in this settingRVU23C
2023-04-01$84.90Not available in this settingRVU23B
2023-01-01$84.90Not available in this settingRVU23A
2022-10-01$90.58Not available in this settingRVU22D
2022-07-01$90.58Not available in this settingRVU22C
2022-04-01$90.58Not available in this settingRVU22B
2022-01-01$90.58Not available in this settingRVU22A
2021-10-01$95.25Not available in this settingRVU21D
2021-07-01$95.25Not available in this settingRVU21C
2021-04-01$95.25Not available in this settingRVU21B
2021-01-01$95.25Not available in this settingRVU21A
2020-10-01$94.13Not available in this settingRVU20D
2020-07-01$94.13Not available in this settingRVU20C
2020-04-01$94.13Not available in this settingRVU20B
2020-01-01$94.13Not available in this settingRVU20A
2019-10-01$94.70Not available in this settingRVU19D
2019-07-01$94.70Not available in this settingRVU19C
2019-04-01$94.70Not available in this settingRVU19B
2019-01-01$94.70Not available in this settingRVU19A
2018-10-01$98.99Not available in this settingRVU18D
2018-07-01$98.99Not available in this settingRVU18C
2018-04-01$98.99Not available in this settingRVU18B
2018-01-01$98.99Not available in this settingRVU18AR1
2017-10-01$96.26Not available in this settingRVU17D
2017-07-01$96.26Not available in this settingRVU17C
2017-04-01$96.26Not available in this settingRVU17B
2017-01-01$96.26Not available in this settingRVU17A
2016-10-01$96.89Not available in this settingRVU16D
2016-07-01$96.89Not available in this settingRVU16C
2016-04-01$96.89Not available in this settingRVU16B
2016-01-01$96.89Not available in this settingRVU16A
2015-10-01$92.03Not available in this settingRVU15D
2015-07-01$92.03Not available in this settingRVU15C
2015-04-01$91.57Not available in this settingRVU15B
2015-01-01$91.57Not available in this settingRVU15A
2014-10-01$91.01Not available in this settingRVU14D
2014-07-01$91.01Not available in this settingRVU14C
2014-04-01$91.01Not available in this settingRVU14B
2014-01-01$91.01Not available in this settingRVU14A
2013-10-01$94.89Not available in this settingRVU13D
2013-07-01$94.89Not available in this settingRVU13C
2013-04-01$94.89Not available in this settingRVU13B
2013-01-01$94.89Not available in this settingRVU13AR

Price 95870 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

95870 billing questions

When should I report 95870 instead of 95860?

Use 95870 for a limited needle examination of muscles in one extremity or axial muscles. Use 95860 when the documented examination is a broader study of one extremity.

How does 95870 differ from 95869?

95869 is specific to thoracic paraspinal muscles. 95870 describes a limited study in an extremity or other axial muscles.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 reports the interpretation, and modifier TC reports the equipment and staff portion. Without either modifier, the claim represents the global service.

What documentation supports a limited study?

Document the clinical question, the muscles sampled, the body region, and the examination findings. The record should support that the service was limited rather than a broader extremity examination.

How is 95870 distinguished from a limited EMG performed with nerve conduction studies?

95885 describes a limited needle EMG performed with nerve conduction studies. Select the code that matches the documented service and its relationship to the nerve conduction testing.

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 95870PPRRVU2026_Oct_nonQPP.csv, line 12,603 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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