CPT code 95860: Needle EMG2026 Medicare rate & RVUs

Reports a needle electromyography study of one arm or leg to evaluate suspected nerve or muscle dysfunction, with related paraspinal sampling when appropriate.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.8K Medicare services in 2024

Medicare pays $119.58 for 95860 nationally in the office. Local office rates run $106.57–$160.49.

Medicare rate · 95860

Needle EMG

Office or facility?

Work RVUs
0.94
Total RVUs
3.58
Global days
XXX

National rate · 2026

$119.58

Office setting, before claim adjustments.

See every locality for 95860 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 95860 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 95860 covers

A clinician inserts a small needle electrode into selected muscles and records their electrical activity at rest and during activation. Neurologists and physical medicine and rehabilitation physicians commonly perform and interpret this test in outpatient electrodiagnostic laboratories or hospital settings. It helps evaluate problems such as unexplained limb weakness, numbness, suspected nerve-root irritation, or focal nerve injury. The muscle selection follows the clinical question; related paraspinal muscles may also be examined.

Report this code for a study of one extremity. The number of muscles sampled does not change the extremity count; document the side, muscles tested, findings, and clinical reason for the study. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 or TC when billing only that component. Billing without a component modifier represents the global 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 95860 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$106.57 to $160.49

$106.57$133.53$160.49
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

95860 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$108.04Unavailable
Alaska$140.15Unavailable
Arizona$116.65Unavailable
Arkansas$106.57Unavailable
Atlanta, GA$121.39Unavailable
Austin, TX$124.47Unavailable
Bakersfield, CA$127.82Unavailable
Baltimore area, MD$126.79Unavailable
Beaumont, TX$111.67Unavailable
Brazoria, TX$118.68Unavailable

95860 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.

$106.57

$144.07

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

View every state and territory as a table
95860 office rate range by state
State / territoryOffice rate rangeLocalities
AK$140.151
AL$108.041
AR$106.571
AZ$116.651
CA$127.64–$160.4929
CO$125.121
CT$127.221
DC$136.861
DE$118.531
FL$116.61–$125.683
GA$110.55–$121.392
GU$130.721
HI$130.721
IA$111.211
ID$111.771
IL$112.99–$123.424
IN$112.401
KS$110.441
KY$109.831
LA$109.56–$114.702
MA$124.32–$137.462
MD$120.79–$136.863
ME$112.02–$118.182
MI$112.26–$117.692
MN$120.911
MO$107.59–$115.433
MS$107.111
MT$119.571
NC$113.181
ND$118.581
NE$111.881
NH$122.911
NJ$128.95–$135.512
NM$112.731
NV$119.381
NY$114.75–$139.375
OH$112.061
OK$109.951
OR$118.73–$129.252
PA$112.39–$124.012
PR$120.501
RI$122.851
SC$112.751
SD$118.471
TN$110.931
TX$111.67–$124.478
UT$114.211
VA$117.61–$136.862
VI$120.501
VT$117.891
WA$124.17–$140.482
WI$114.791
WV$108.961
WY$119.141

How the 95860 rate is calculated

Each of 95860’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 · 95860

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.94

0.94 RVUs× 1.000 GPCI

Practice expense2.59

2.59 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

3.5800

Conversion factor

$33.4009

Medicare rate

$119.58

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

Payment rules and modifiers for 95860

The CMS indicators that decide how 95860 is paid alongside other services.

CMS payment indicators · 95860

Needle EMG

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

95860 without 26 · national office

$119.58

Needle EMG

95860-26 · Professional component

$51.44

Pays only the interpretation and report.

When to use modifier 26

95860 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 95860

    Needle EMG0.94 wRVU

    $119.58

  • 95861

    Needle EMG1.5 wRVU

    $161.99+$42.41

  • 95870

    Needle EMG0.36 wRVU

    $86.51−$33.07

  • 95885

    Needle EMG0.34 wRVU

    $64.46−$55.12

  • 95886

    Needle EMG add-on0.84 wRVU

    $99.87−$19.71

How to choose

95861Needle EMG
Use 95860 for one extremity and 95861 for two. The distinction is the number of extremities covered, not the number of muscles tested.
95870Needle EMG
95870 is for a limited needle EMG examination. 95860 represents testing of one extremity.
95885Needle EMG
95885 is the limited EMG format used with nerve conduction testing; 95860 represents the one-extremity format outside that combined-study distinction.
95886Needle EMG add-on
95886 is the complete EMG format used with nerve conduction testing. Choose it rather than 95860 when that combined-study format applies.

95860 billing questions

How is this different from 95861?

95860 represents needle EMG of one extremity; 95861 represents testing of two extremities. Select by the extremity coverage, not by the number of muscles sampled.

When would 95870 be a better fit?

95870 describes a limited needle EMG study rather than the one-extremity study represented by 95860. Choose based on the documented scope of the muscle examination.

How does this differ from 95885 or 95886?

95885 and 95886 describe needle EMG performed with nerve conduction testing, with the choice depending on the extent of the EMG examination. 95860 represents the one-extremity study when that combined-study coding distinction is not the applicable format.

Can the professional and technical portions be billed separately?

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

What should the report document?

Document the extremity examined, muscles sampled, relevant findings at rest and with activation, and the clinical reason for testing. The record should support why the selected muscles addressed the suspected nerve or muscle problem.

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 95860PPRRVU2026_Oct_nonQPP.csv, line 12,576 (RVU26D)

Open CMS sourceHow we calculate rates

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