Billing code 95870: Needle EMGMedicare rate & RVUs in Ohio
Reports a focused needle EMG sampling muscles in one extremity or axial muscles when the examination is limited rather than a broader extremity study.
Medicare pays $80.12 for 95870 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 9 sections
What 95870 covers
A clinician inserts a fine needle electrode into selected muscles and evaluates their electrical activity at rest and during contraction. This limited examination may help assess a focused concern, such as localized weakness or suspected nerve-related muscle changes. Neurologists and physiatrists commonly perform needle EMG in an electrodiagnostic laboratory, outpatient clinic, or hospital setting. The muscles examined may be in one limb or in an axial area; the specific code for the service depends on the body region and scope of the examination.
Choose this code when the documented needle examination is limited, rather than a broader study of one or more extremities. The report should identify the muscles examined, the clinical question, and the findings supporting the interpretation. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The professional and technical components are separately priced when billed with their respective modifiers.
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.
95870 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $80.12 | Unavailable |
How the 95870 rate is calculated
Each of 95870’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 · 95870
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.36Practice expense 2.20Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95870
The CMS indicators that decide how 95870 is paid alongside other services.
CMS payment indicators · 95870
Needle EMG
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95870 without 26 · national office
$86.51
Needle EMG
95870-26 · Professional component
$19.71
Pays only the interpretation and report.
95870 compared with similar codes
Compare codes
95870 vs 95860 vs 95869 vs 95885 vs 95886: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95860Needle EMG
- 95870 is for a limited examination in one extremity or axial muscles. 95860 describes a broader examination of one extremity.
- 95869Needle EMG
- Use 95869 for thoracic paraspinal muscles specifically; 95870 covers a limited extremity or other axial muscle study.
- 95885Needle EMG
- 95885 describes a limited needle EMG performed with nerve conduction studies. Choose based on whether the documented EMG is reported in that testing context.
- 95886Needle EMG add-on
- 95886 is for a more extensive needle EMG performed with nerve conduction studies; 95870 describes a limited study.
95870 billing questions
When should I report 95870 instead of 95860?
Use 95870 for a limited needle examination of muscles in one extremity or axial muscles. Use 95860 when the documented examination is a broader study of one extremity.
How does 95870 differ from 95869?
95869 is specific to thoracic paraspinal muscles. 95870 describes a limited study in an extremity or other axial muscles.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 reports the interpretation, and modifier TC reports the equipment and staff portion. Without either modifier, the claim represents the global service.
What documentation supports a limited study?
Document the clinical question, the muscles sampled, the body region, and the examination findings. The record should support that the service was limited rather than a broader extremity examination.
How is 95870 distinguished from a limited EMG performed with nerve conduction studies?
95885 describes a limited needle EMG performed with nerve conduction studies. Select the code that matches the documented service and its relationship to the nerve conduction testing.
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
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