Limited needle electromyography of one extremity or of non-limb axial muscles, used when only a few muscles are examined and no nerve conduction study is billed.
- Medicare
- $86.51
- Work RVU
- 0.36
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Limb or axial region tested
- List of muscles sampled, showing a limited study
- Needle findings for each muscle
- Reason for a limited exam, such as a narrow follow-up question
- Whether NCS was performed that day
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
95870 is the limited needle EMG code. It applies per extremity when fewer muscles are tested than a complete study requires, and to axial muscles such as abdominal or cervical paraspinal muscles that are not part of a limb study. Thoracic paraspinals, cranial nerve muscles, and sphincters have their own codes.
In ortho terms, a common use is checking a couple of muscles in one arm to answer a narrow question, such as screening the abductor pollicis brevis and one comparison muscle, or rechecking reinnervation after a nerve repair. If the study ends up covering five or more muscles across three nerves, it is no longer limited.
Do not report 95870 with nerve conduction studies. On NCS days, the limited limb exam becomes 95885 and axial muscles become 95887. Billing 95870 for each extremity of a multi-limb study, instead of 95861 to 95864, is a frequent coding error.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.36) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (2.59) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.36 |
| Practice expense RVU | 2.2 |
| Malpractice RVU | 0.03 |
| Total RVU | 2.59 |
| Medicare national rate | $86.51 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $86.51 |
HOPD (APC 5734) Hospital outpatient department | $135.93 |
Common denial reasons
The recurring reasons claims for CPT 95870 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 95907 to 95913 instead of 95885 or 95887
- Multiple units billed when a complete multi-limb code applies
- Thoracic paraspinals coded here instead of 95869
- Muscle count supports a complete study, creating a coding mismatch
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01When do I use 95870 instead of 95860?
02Can 95870 be billed with nerve conduction studies?
03Does 95870 cover thoracic paraspinals?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
Mira Scribe
Mira Scribe records the specific question behind a limited EMG, such as tracking recovery after a nerve repair, so the order matches the test performed.
See how Mira captures CPT 95870 documentation