$127.22
Use 95872 for the specialized single-fiber examination of neuromuscular transmission. Use 95860 for conventional needle EMG when the examination covers one extremity.
On this page
CMS RVU26D · Effective 2026-10-01
95872 Needle EMG Medicare reimbursement rates in Connecticut
Single-fiber needle EMG evaluates neuromuscular transmission and is reported when a specialized quantitative study is performed for suspected disorders such as myasthenia gravis. Compare 95872 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95872 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$227.39
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Electrodiagnostic testing
About 95872: Single-fiber needle electromyography
Single-fiber needle EMG evaluates neuromuscular transmission and is reported when a specialized quantitative study is performed for suspected disorders such as myasthenia gravis.
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.
CMS billing rules for 95872
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU2.81 · 44%
- Practice expense (office) RVU3.48 · 54%
- Malpractice RVU0.16 · 2%
1.5K
Medicare services in 2024 · #2678 by national volume
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.
95872 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$92.62
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.
$68.82
95885 is limited conventional muscle testing performed with nerve-conduction testing. Choose 95872 when the documented muscle study uses the single-fiber method.
Compare 95872 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$227.39
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95872 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
12,606
- Code
- 95872
- Physician work
- 2.81
- Practice expense
- 3.48
- Malpractice
- 0.16
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.81 | × 1.020 | 2.8662 |
| Practice expense | 3.48 | × 1.077 | 3.7480 |
| Malpractice | 0.16 | × 1.210 | 0.1936 |
| Total RVUs | 6.8078 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$227.39
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.81 | 1.02 |
| Practice expense | 3.48 | 1.077 |
| Malpractice | 0.16 | 1.21 |
(2.81 × 1.02 + 3.48 × 1.077 + 0.16 × 1.21) × $33.4009 = $227.39
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,60395870,,Ndl emg lmtd std musc 1 xtr,A,,0.36,2.20,,2.20,NA,0.03,2.59,2.59,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,60495870,26,Ndl emg lmtd std musc 1 xtr,A,,0.36,0.21,,0.21,,0.02,0.59,0.59,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,60595870,TC,Ndl emg lmtd std musc 1 xtr,A,,0.00,1.99,,1.99,NA,0.01,2.00,2.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,6A,0,99,0.00,0.00,0.00
12,60695872,,Ndl emg single fiber eltrd,A,,2.81,3.48,,3.48,NA,0.16,6.45,6.45,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,60795872,26,Ndl emg single fiber eltrd,A,,2.81,1.64,,1.64,,0.15,4.60,4.60,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,60895872,TC,Ndl emg single fiber eltrd,A,,0.00,1.84,,1.84,NA,0.01,1.85,1.85,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,66,0,99,0.00,0.00,0.00
12,60995873,,Guide nerv destr elec stim,A,,0.36,1.91,,1.91,NA,0.01,2.28,2.28,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808