CPT 95864
Global XXX ActiveNeedle emg 4 extremities
CPT 95864 Billing & Documentation Guide
CPT code 95864 (Needle emg 4 extremities) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.94, a non-facility practice expense RVU of 5.17, and a malpractice RVU of 0.09, a total non-facility RVU of 7.2 and facility RVU of 7.2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $248.91, though rates vary from $214.68 to $322.55 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95864, 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 95864 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 95864 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 95864
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.94 | 1.94 |
| Practice Expense RVU | 5.17 | 5.17 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 7.2 | 7.2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95864
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 | $273.08 | $273.08 | $256.77 - $322.55 | 29 |
| Florida | $243.91 | $243.91 | $234.4 - $252.16 | 3 |
| Georgia | $233.23 | $233.23 | $222.41 - $244.05 | 2 |
| Illinois | $237.62 | $237.62 | $227.16 - $247.92 | 4 |
| Michigan | $231.18 | $231.18 | $225.85 - $236.5 | 2 |
| North Carolina | $227.83 | $227.83 | $227.83 - $227.83 | 1 |
| New York | $264.6 | $264.6 | $230.96 - $279.85 | 5 |
| Ohio | $225.49 | $225.49 | $225.49 - $225.49 | 1 |
| Pennsylvania | $237.74 | $237.74 | $226.16 - $249.31 | 2 |
| Texas | $237.95 | $237.95 | $224.73 - $250.29 | 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 95864
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95864 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 |
| 95860 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 95861 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 95863 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 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 |
Frequently Asked Questions, CPT 95864
What does CPT code 95864 mean? +
CPT code 95864 represents: Needle emg 4 extremities. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95864? +
The 2026 Medicare national average non-facility payment for CPT 95864 is $248.91. Rates range from $214.68 to $322.55 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95864? +
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 95864? +
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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