Billing code 95872: Needle EMGMedicare rate & RVUs

Single-fiber needle EMG evaluates neuromuscular transmission and is reported when a specialized quantitative study is performed for suspected disorders such as myasthenia gravis.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $215.44 for 95872 nationally in the office. Local office rates run $196.45–$274.66.

Medicare rate · 95872

Needle EMG

Swap in your local Medicare rate.

Work RVUs
2.81
Total RVUs
6.45
Global days
XXX

National rate · 2026

$215.44

Office setting, before claim adjustments.

See every locality for 95872 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 95872 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 95872 covers

Single-fiber needle EMG uses a specialized electrode and recording technique to assess variability in transmission between motor nerve and muscle fibers. Neurologists and physiatrists commonly perform it when a neuromuscular-junction disorder is suspected, including in an evaluation for myasthenia gravis. The examiner studies selected muscles; the service is distinguished by its technique, not by the number of extremities examined. It is performed in outpatient electrodiagnostic laboratories and hospital settings.

Report 95872 for the specialized single-fiber study, not for a conventional needle examination merely because a needle electrode is used. Documentation should identify the muscles examined, the single-fiber method and findings, and the clinical reason for testing. If routine needle EMG or nerve-conduction testing is also performed, document the distinct services and their findings. CMS recognizes professional and technical components: use modifier 26 for interpretation, TC for equipment and staff, or no component modifier for 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 95872 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

$196.45 to $274.66

$196.45$235.56$274.66
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

95872 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$198.59Unavailable
Alaska*$267.52Unavailable
Arizona$211.06Unavailable
Arkansas$196.45Unavailable
Atlanta$218.65Unavailable
Austin$221.76Unavailable
Bakersfield$226.29Unavailable
Baltimore/Surr. Cntys$226.69Unavailable
Beaumont$204.60Unavailable
Brazoria$213.96Unavailable

95872 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$196.45

$267.52

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

View every state and territory as a table
95872 office rate range by state
State / territoryOffice rate rangeLocalities
AK$267.521
AL$198.591
AR$196.451
AZ$211.061
CA$225.71–$274.6629
CO$222.831
CT$227.391
DC$241.801
DE$213.971
FL$213.01–$228.373
GA$203.91–$218.652
GU$229.111
HI$229.111
IA$202.331
ID$203.321
IL$208.33–$223.594
IN$204.201
KS$201.631
KY$202.081
LA$201.84–$209.302
MA$222.01–$241.252
MD$217.33–$241.803
ME$204.12–$212.422
MI$206.01–$215.032
MN$215.041
MO$199.26–$209.873
MS$197.881
MT$215.431
NC$205.721
ND$212.261
NE$203.161
NH$219.531
NJ$230.40–$240.312
NM$206.861
NV$214.661
NY$208.04–$247.995
OH$205.371
OK$201.811
OR$213.38–$228.472
PA$205.61–$222.922
PR$216.631
RI$220.481
SC$205.801
SD$211.891
TN$202.381
TX$204.60–$221.768
UT$207.921
VA$211.89–$241.802
VI$216.631
VT$211.631
WA$221.54–$245.542
WI$206.861
WV$202.511
WY$214.051

How the 95872 rate is calculated

Each of 95872’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 · 95872

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.81Practice expense 3.48Malpractice 0.16

6.4500 adjusted RVUs×$33.4009 conversion factor=$215.44

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 95872

The CMS indicators that decide how 95872 is paid alongside other services.

CMS payment indicators · 95872

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

95872 without 26 · national office

$215.44

Needle EMG

95872-26 · Professional component

$153.64

Pays only the interpretation and report.

When to use modifier 26

95872 compared with similar codes

Compare codes

95872 vs 95860 vs 95870 vs 95885: national Medicare rates

Swap in your local Medicare rate.

  • 95872
    Needle EMG · 2.81 wRVU
    $215.44
  • 95860
    Needle EMG · 0.94 wRVU
    $119.58−$95.86
  • 95870
    Needle EMG · 0.36 wRVU
    $86.51−$128.93
  • 95885
    Needle EMG · 0.34 wRVU
    $64.46−$150.98

How to choose

95860Needle EMG
Use 95872 for the specialized single-fiber examination of neuromuscular transmission. Use 95860 for conventional needle EMG when the examination covers one extremity.
95870Needle EMG
95870 describes a limited conventional needle EMG. It is not selected simply because only a small area is examined; 95872 is distinguished by the single-fiber technique.
95885Needle EMG
95885 is limited conventional muscle testing performed with nerve-conduction testing. Choose 95872 when the documented muscle study uses the single-fiber method.

95872 billing questions

How does 95872 differ from routine needle EMG codes such as 95860 or 95870?

95872 identifies the specialized single-fiber recording technique used to assess neuromuscular transmission. Codes 95860 and 95870 describe conventional needle EMG based on the examination’s extent.

Can 95872 be reported with routine needle EMG or nerve-conduction testing?

It may be reported alongside other electrodiagnostic services when those services are separately performed and documented. The record should support the single-fiber study as distinct from the routine needle examination or nerve-conduction testing.

Which modifiers identify the components?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Report without a component modifier for the global service.

What documentation supports reporting 95872?

Document the clinical indication, muscles examined, use of the single-fiber technique, and study findings. The record should make clear why this specialized examination was performed.

Is the number of muscles or extremities the basis for choosing 95872?

No. The defining feature is the single-fiber method, rather than the extremity count used to distinguish conventional needle EMG codes.

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 95872PPRRVU2026_Oct_nonQPP.csv, line 12,606 (RVU26D)

Open CMS sourceHow we calculate rates

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