CPT 95874
Global ZZZ ActiveGuide nerv destr needle emg
CPT 95874 Billing & Documentation Guide
CPT code 95874 (Guide nerv destr needle emg) is classified under Neurology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.36, a non-facility practice expense RVU of 2.04, and a malpractice RVU of 0.01, a total non-facility RVU of 2.41 and facility RVU of 2.41. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $83.67, though rates vary from $70.73 to $111.78 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95874, 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 95874 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95874 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 95874
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.36 | 0.36 |
| Practice Expense RVU | 2.04 | 2.04 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 2.41 | 2.41 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95874
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 | $93.26 | $93.26 | $87.09 - $111.78 | 29 |
| Florida | $81.04 | $81.04 | $77.67 - $83.8 | 3 |
| Georgia | $77.45 | $77.45 | $73.2 - $81.69 | 2 |
| Illinois | $78.54 | $78.54 | $74.76 - $82.68 | 4 |
| Michigan | $76.48 | $76.48 | $74.61 - $78.34 | 2 |
| North Carolina | $75.81 | $75.81 | $75.81 - $75.81 | 1 |
| New York | $89.06 | $89.06 | $76.99 - $94.43 | 5 |
| Ohio | $74.57 | $74.57 | $74.57 - $74.57 | 1 |
| Pennsylvania | $79.23 | $79.23 | $74.89 - $83.57 | 2 |
| Texas | $79.48 | $79.48 | $74.34 - $84.43 | 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 95874
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95874 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 |
| 95873 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99446 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99447 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99448 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99449 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99451 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99452 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95874
What does CPT code 95874 mean? +
CPT code 95874 represents: Guide nerv destr needle emg. It's in the Neurology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 95874? +
The 2026 Medicare national average non-facility payment for CPT 95874 is $83.67. Rates range from $70.73 to $111.78 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95874? +
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 95874? +
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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