Needle electromyography of all four extremities, including related paraspinal muscles if sampled, when no nerve conduction study is performed the same day.
- Medicare
- $240.49
- Work RVU
- 1.94
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- History and exam supporting a generalized or multi-limb process
- Needle findings for each muscle in all four limbs
- Complete muscle count per limb
- Paraspinal sampling, if done
- No same-day nerve conduction study billed
- Physician impression with a supporting diagnosis
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 ↓
Four-limb needle EMG belongs to workups for generalized problems: suspected motor neuron disease, myopathy, or a polyneuropathy with diffuse weakness. A typical ortho referral for radiculopathy or a single entrapment almost never supports it.
As with 95860 through 95863, this code is for days without nerve conduction testing. Once NCS codes are on the claim, the needle work is billed with 95885 or 95886 per limb, one unit per limb, so four units at most. Related paraspinals are part of the code.
Expect scrutiny. Four-limb studies stand out in utilization data, and most contractors follow a maximum study table by diagnosis. The documentation should make the generalized nature of the problem obvious from the history and exam, not just from the final impression.
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 (1.94) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (7.2) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.94 |
| Practice expense RVU | 5.17 |
| Malpractice RVU | 0.09 |
| Total RVU | 7.2 |
| Medicare national rate | $240.49 |
| 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 | $240.49 |
HOPD (APC 5721) Hospital outpatient department | $131.46 |
Common denial reasons
The recurring reasons claims for CPT 95864 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Diagnosis is a single entrapment or radiculopathy that does not support four limbs
- Billed alongside 95907 to 95913
- Exceeds the contractor's study limits for the diagnosis
- Incomplete studies in one or more limbs
- Frequency concerns from repeat four-limb testing without a change in condition
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What diagnoses usually support a four-limb EMG?
02Can 95864 be billed with nerve conduction studies?
03Does 95864 include paraspinal muscles?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe documents diffuse weakness, sensory loss, and exam findings across all limbs, giving a four-limb EMG the history it needs to hold up on review.
See how Mira captures CPT 95864 documentation