CPT 95860
Global XXX ActiveNeedle emg 1 extremity
CPT 95860 Billing & Documentation Guide
CPT code 95860 (Needle emg 1 extremity) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.94, a non-facility practice expense RVU of 2.59, and a malpractice RVU of 0.05, a total non-facility RVU of 3.58 and facility RVU of 3.58. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $123.75, though rates vary from $106.57 to $160.49 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95860, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 95860 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95860 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 95860
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.94 | 0.94 |
| Practice Expense RVU | 2.59 | 2.59 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 3.58 | 3.58 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95860
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $135.79 | $135.79 | $127.64 - $160.49 | 29 |
| Florida | $121.45 | $121.45 | $116.61 - $125.68 | 3 |
| Georgia | $115.97 | $115.97 | $110.55 - $121.39 | 2 |
| Illinois | $118.29 | $118.29 | $112.99 - $123.42 | 4 |
| Michigan | $114.98 | $114.98 | $112.26 - $117.69 | 2 |
| North Carolina | $113.18 | $113.18 | $113.18 - $113.18 | 1 |
| New York | $131.67 | $131.67 | $114.75 - $139.37 | 5 |
| Ohio | $112.06 | $112.06 | $112.06 - $112.06 | 1 |
| Pennsylvania | $118.2 | $118.2 | $112.39 - $124.01 | 2 |
| Texas | $118.29 | $118.29 | $111.67 - $124.47 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 95860
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95860 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95869 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 95870 | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 95873 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95874 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95885 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95886 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95900 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95903 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95860
What does CPT code 95860 mean? +
CPT code 95860 represents: Needle emg 1 extremity. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95860? +
The 2026 Medicare national average non-facility payment for CPT 95860 is $123.75. Rates range from $106.57 to $160.49 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95860? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 95860? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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