Billing code 95874: Injection guidanceMedicare rate & RVUs

Medicare pays $80.50 for 95874 nationally in the office. Local office rates run $70.73–$111.78.

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

What 95874 covers

This service uses needle electromyography to help guide chemodenervation injections into selected muscles. A neurologist or physiatrist may use it during botulinum toxin treatment for conditions such as focal spasticity or dystonia, where identifying or confirming activity in the target muscle helps direct the injection. The guidance is performed as part of the injection encounter, rather than as a standalone diagnostic needle EMG examination.

Report 95874 only with the applicable primary chemodenervation procedure; document the muscles treated and the use of needle EMG to guide the injection. CMS classifies it as an add-on code paid within the primary procedure’s global period. The service has separately priced professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and no modifier represents the global service. The injection itself is reported with its appropriate primary procedure code.

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 95874 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

95874 rates by state

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

How the 95874 rate is calculated

Each of 95874’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 95874

The CMS indicators that decide how 95874 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

95874 compared with similar codes

How to choose

95873Stimulation guidance

Both codes describe guidance during chemodenervation, but 95873 uses electrical stimulation while 95874 uses needle EMG.

95860Needle EMG

Code 95860 reports diagnostic needle EMG testing of one extremity. Code 95874 reports needle EMG used to guide a chemodenervation injection.

64615Migraine chemodenervation

Code 64615 reports the primary chemodenervation service for chronic migraine. Code 95874 is an add-on for needle EMG guidance when that guidance is performed.

Codes related to 95874

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