Add-on code for a complete needle EMG of one extremity, including related paraspinals, performed on the same day as nerve conduction studies.
- Medicare
- $99.87
- Work RVU
- 0.84
- 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 ↓
- Primary NCS code with study count
- Limb tested
- Five or more muscles listed across at least three nerves or four spinal levels
- Paraspinal findings, if sampled
- Needle findings for each muscle
- Combined interpretation
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 ↓
Radiculopathy workups usually land here. 95886 is the add-on for a complete needle exam of one limb when nerve conduction studies are billed the same day. For a root question, the physician needs a spread of muscles across several roots plus paraspinals to separate a pinched root from a peripheral entrapment.
A complete study generally means at least five muscles in the limb, supplied by three nerves or four spinal levels. Paraspinals tied to that limb are included. Report one unit per limb and pair it with the NCS code that matches the total number of studies.
Watch the unit limits. Each limb gets one or the other, never both, so the pair tops out at four. If one arm got a complete exam and the other a limited one, the claim should show one 95886 and one 95885, not two of either.
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 (0.84) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (2.99) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.84 |
| Practice expense RVU | 2.12 |
| Malpractice RVU | 0.03 |
| Total RVU | 2.99 |
| Medicare national rate | $99.87 |
| 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 | $99.87 |
Common denial reasons
The recurring reasons claims for CPT 95886 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Muscle count supports only a limited study
- No primary NCS code on the claim
- More than one unit per limb, or 95885 and 95886 both billed for the same limb
- Billed with 95860 to 95864 on the same date
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What counts as a complete EMG for 95886?
02Are paraspinals billed separately with 95886?
03Can I bill 95886 for both legs?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe documents radicular symptoms, reflexes, and strength by limb, which supports a complete EMG when the question is root versus nerve.
See how Mira captures CPT 95886 documentation