CPT 95886 is a medical billing code used by healthcare providers for Needle Electromyography services involving five or more muscles studied, innervated by three or more nerves or four or more spinal levels.

What is a fee schedule for CPT 95886?

A fee schedule for CPT 95886 is a list of prices that healthcare providers charge for this specific service. These prices can vary by payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

How do I find the reimbursement rates for CPT 95886?

Reimbursement rates for CPT 95886 vary by insurance payer (UnitedHealthcare, Cigna, Aetna, Blue Cross Blue Shield, Medicare, Medicaid) and can be found through services like PayerPrice, which provides negotiated rates from insurers.

What factors influence CPT 95886 fee schedules?

Factors affecting CPT 95886 fee schedules include Medicare & Medicaid rates (government-set), private insurance negotiated rates, geographic location (e.g., higher in urban areas), and provider type (e.g., hospital vs. private practice).

Is CPT 95886 a complex procedure?

The CPT 95886 code is categorized as having a 'Low' complexity level according to the page content. It involves moderate medical decision-making but is not considered high complexity.

CPT (Current Procedural Terminology) codes are a standardized set of five-digit alphanumeric codes used by healthcare providers to describe medical, surgical, and diagnostic services and procedures. They are essential for accurate billing, processing claims by insurance companies, and for communicating services consistently across the healthcare system.

How can I find out the cost of a medical procedure or service?

To get an estimate for a medical procedure or service, you can typically ask your healthcare provider's billing department. For a more generalized understanding of fee schedules for specific CPT codes in your location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to see typical costs.

Why do healthcare costs vary so much for the same service?

Healthcare costs can vary significantly due to multiple factors. These include the type of facility (e.g., hospital vs. outpatient clinic), geographic location, the specific provider's negotiated rates with different insurance companies, the complexity of the patient's individual case, and whether the service is considered in-network or out-of-network for your insurance plan. Different insurance plans also have varying reimbursement rates for the same services.

Does insurance cover all CPT codes, and how does that affect my out-of-pocket cost?

No, insurance does not necessarily cover all CPT codes or services. Coverage depends on your specific insurance plan's benefits, medical necessity criteria, and whether you've met your deductible or out-of-pocket maximums. Even for covered services, your out-of-pocket cost will be influenced by co-pays, co-insurance, and your deductible. It's crucial to contact your insurance provider directly or review your plan documents for specific coverage details. For an understanding of potential costs before insurance, you can use tools like Payerprice to get an idea of the fee schedule for specific CPT codes.

What is a 'fee schedule' in healthcare?

A fee schedule in healthcare is a comprehensive list of fees or maximum allowable amounts that providers or insurance companies use to determine payment for specific medical services, procedures, and supplies. Each service is typically identified by a CPT code, and the fee schedule outlines the rate associated with that code. For specific fee schedule information related to CPT codes and locations, you can utilize Payerprice's lookup tool.

CPT 95886 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.

Musc Test Done W N Test Comp, Needle Electromyography Each Extremity With Related Paraspinal Areas When Performed Done With Nerve Conduction Amplitude And Latency Velocity Study Complete Five Or More Muscles Studied Innervated By Three Or More Nerves Or Four Or More Spinal Levels List Separately In Addition To Code For Primary Procedure

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 RT - Right side of body
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 95886
Medicaid Fee Schedule	View Medicaid rates for 95886

National average reimbursement for CPT 95886 by major payers:

$113.75

$121.97

$129.58

$159.70

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 95886.

CPT 95886

5 of 25 sample ratesHigher to lower in this preview

Ravi Ramasamy
The Association Of Chrmc And University Physicians
ILChild & Adolescent Psychiatry PhysicianNPI 1659714806Tax ID 91-1336707
$248.63Published rate
Yu Zhang
Northwestern Memorial Healthcare
ILPsychiatry PhysicianNPI 1568921476Tax ID 36-3097297
$114.29Published rate
Christina Rose
TXNeurology PhysicianNPI 1275740847Tax ID 84-4632661
$95.62Published rate
Polo Banuelos
TXNeurology PhysicianNPI 1003072646Tax ID 59-3140335
$69.73Published rate
George Kartalian, Jr.
Town Center Orthopaedic Associates, P.C.
VAOrthopaedic Surgery PhysicianNPI 1366437493Tax ID 54-1383504
$51.08Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

This code appears in 1 published specialty market.

Explore state-level rates by specialty

CPT 95886 vs. Other Neurology and Neuromuscular Procedures Codes

The CPT 95886 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 95886 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
95870-CPT	Low	Testing Of Nerve In Muscle, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into Each Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested.
95885-CPT	Low	Testing Of Nerve In Muscle, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into Each Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested.
95886-CPT	Low	Musc Test Done W N Test Comp, Needle Electromyography Each Extremity With Related Paraspinal Areas When Performed Done With Nerve Conduction Amplitude And Latency Velocity Study Complete Five Or More Muscles Studied Innervated By Three Or More Nerves Or Four Or More Spinal Levels List Separately In Addition To Code For Primary Procedure
95905-CPT	Low	Nerve Function Study, A Nerve Function Study Evaluates Muscle Movements Or A Sensation Such As Numbness Or Weakness. The Study Can Measure Length Of Time Between Stimulation Of The Nerve And A Reaction Or The Intensity Of A Reaction.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95886. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 95886 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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CPT 95886 Fee Schedule

Compare published rates across providers.

Ravi Ramasamy

Yu Zhang

Christina Rose

Polo Banuelos

George Kartalian, Jr.