Needle electromyography of one arm or leg, with or without testing of the related paraspinal muscles, to evaluate nerve and muscle function.
- Medicare
- $119.58
- Work RVU
- 0.94
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Clinical question (radiculopathy level, entrapment neuropathy, peripheral nerve injury)
- Each muscle tested, including paraspinals, with findings at rest and with activation
- Limb tested and side
- Statement that nerve conduction studies were not done that day, or use of 95885/95886 if they were
- Signed interpretation with diagnostic impression
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
95860 is needle EMG of one extremity. The examiner places a needle electrode in selected muscles, and paraspinal muscles if needed, to look for denervation, reinnervation, or myopathy.
Orthopedic and spine surgeons order EMG all the time: suspected cervical or lumbar radiculopathy before a decompression, carpal tunnel or cubital tunnel before release, a foot drop after a hip replacement. Most of the time the EMG is done with nerve conduction studies on the same day. When that happens, CPT directs you to report the EMG with add-on 95885 (limited) or 95886 (complete) alongside the NCS codes instead of 95860. 95860 is for needle EMG done without nerve conduction testing that day.
The study should name each muscle tested and its findings. Billing 95860 for both arms is wrong; that is 95861. Many payers have local coverage policies for EMG that list covered diagnoses and limit how often it can be repeated, so check your MAC's policy before scheduling a repeat study.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.94) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.58) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.94 |
| Practice expense RVU | 2.59 |
| Malpractice RVU | 0.05 |
| Total RVU | 3.58 |
| Medicare national rate | $119.58 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $119.58 |
HOPD (APC 5734) Hospital outpatient department | $135.93 |
Common denial reasons
The recurring reasons claims for CPT 95860 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with nerve conduction codes 95907 through 95913 instead of using 95885 or 95886
- Billed twice for two limbs instead of 95861
- Diagnosis not on the payer's covered list
- Repeat study within the payer's frequency limit without new symptoms
- Muscles tested not documented
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can 95860 be billed with nerve conduction studies?
02What code is used for EMG of both arms?
03Do paraspinal muscles count as a separate EMG code?
04Do I need a laterality modifier on 95860?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures the dermatomal symptoms, strength grades, and reflex findings that justify an EMG order and point the testing physician to the right muscles.
See how Mira captures CPT 95860 documentation