Billing code 95861: Needle EMGMedicare rate & RVUs

Medicare pays $161.99 for 95861 nationally in the office. Local office rates run $145.30–$214.54.

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

What 95861 covers

A clinician inserts a fine needle electrode into selected muscles and records their electrical activity at rest and during voluntary activation. The findings can help evaluate problems such as suspected radiculopathy, peripheral nerve injury, or muscle disease. Neurologists and physical medicine and rehabilitation physicians commonly perform or interpret the study in office and hospital settings. The code identifies testing of two extremities; the specific muscles examined depend on the clinical question and examination plan.

Select the code based on the number of extremities examined, not the number of muscles sampled. Documentation should identify the extremities and muscles tested, the clinical reason for the study, and the findings and interpretation. CMS recognizes separately priced professional and technical components: modifier 26 represents interpretation, modifier TC represents equipment and staff, and reporting without a 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 95861 pays more and less

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

109 of 109 payment localities

95861 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 95861 rate is calculated

Each of 95861’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.

Payment rules and modifiers for 95861

The CMS indicators that decide how 95861 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

95861 compared with similar codes

How to choose

95860Needle EMG

Use 95860 when one extremity is examined; 95861 represents two extremities. The number of muscles tested does not determine this distinction.

95863Needle EMG

Use 95863 when three extremities are examined. For a study of two extremities, use 95861.

95885Needle EMG

95885 describes limited needle EMG by extremity when performed with nerve conduction studies. 95861 describes testing of two extremities rather than a limited study per extremity.

95886Needle EMG add-on

95886 describes complete needle EMG by extremity when performed with nerve conduction studies. 95861 identifies a two-extremity study.

Codes related to 95861

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

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

Open CMS sourceHow we calculate rates