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See a sample rate comparisonCPT 95866 Fee Schedule
Last Verified: October 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 Diaphragm, This Test Inserts A Needle Electrode Into The Muscles Of The Diaphragm. An Emg (Electromyography) Measures How Nerves And Muscles Interact. It Shows If And How A Nerve Instruction Reaches A Muscle And How That Muscle Responds.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 95866 |
| Medicaid Fee Schedule | View Medicaid rates for 95866 |
National average reimbursement for CPT 95866 by major payers:
$162.38
$155.65
$158.72
$204.26
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CPT 95866
5 of 25 sample ratesHigher to lower in this preview
Adam Wallace
Aurora Medical Group Inc
$247.96Published rateSurya Sabhapathy
The Board Of Trustees Of The University Of Illinois
$172.94Published rateDavid Banayan
Loyola University Medical Center
$129.74Published rateBarbara Twardowski
Advocate Health And Hospitals Corporation
$113.25Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$3.48Published rate
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See a sample payer proposalCPT 95866 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95866 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 95866 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 |
|---|---|---|
| 95865-CPT | Low | Test Nerve In Voice Box, This Test Inserts A Needle Electrode Into The Muscles Of The Voice Box. An Emg (Electromyography) Measures How Nerves And Muscles Interact. It Shows If And How A Nerve Instruction Reaches A Muscle And How That Muscle Responds. |
| 95866-CPT | Low | Test Nerve In Diaphragm, This Test Inserts A Needle Electrode Into The Muscles Of The Diaphragm. An Emg (Electromyography) Measures How Nerves And Muscles Interact. It Shows If And How A Nerve Instruction Reaches A Muscle And How That Muscle Responds. |
| 95867-CPT | Low | Nerve Test In Head Or Neck, This Test Inserts An Electrode Attached To A Needle Into Muscles Of The Face Head And Neck To Measure The Electrical Interaction Between Nerves And Muscles. It Shows If And How A Nerve Instruction Reaches A Muscle And How That Muscle Responds. |
| 95868-CPT | Low | Nerve Test In Head Or Neck, This Test Inserts An Electrode Attached To A Needle Into Muscles Of The Face Head And Neck To Measure The Electrical Interaction Between Nerves And Muscles. It Shows If And How A Nerve Instruction Reaches A Muscle And How That Muscle Responds. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95866. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95866 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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