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See a sample rate comparisonCPT 95861 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 15 - Mobile Unit |
| Common Modifiers | None 26 - Professional component XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 95861 |
| Medicaid Fee Schedule | View Medicaid rates for 95861 |
National average reimbursement for CPT 95861 by major payers:
$183.41
$200.10
$219.90
$245.07
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CPT 95861
5 of 25 sample ratesHigher to lower in this preview
Rhonda Lampen
Multicare Health System
$332.73Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$258.63Published rateDavid Sholtes
$163.35Published rateJeremiah Brewer
Loyola University Medical Center
$133.77Published rateShalini Chawla
Shalini Chawla Md LLC
$107.18Published rate
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See a sample payer proposalCPT 95861 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95861 code is part of the Medicine Services and Procedures services used for Neurology and Neuromuscular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 95861 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 95860-CPT | Low | Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well. |
| 95861-CPT | Low | Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well. |
| 95863-CPT | Moderate | Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well. |
| 95864-CPT | Moderate | Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95861. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95861 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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