How much does Medicare pay for CPT 95861?

Medicare allowed an average of $80.08 per service and paid $63.30 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1763.92, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95861?

Needle measurement of electrical activity in arm or leg muscles, 2 extremities. It was billed 51,162 times to 50,280 Medicare beneficiaries by 397 providers in 2024.

Does 95861 pay differently in an office than a hospital?

Yes. The allowed amount averaged $102.61 in an office setting and $78.92 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 95861 most?

Neurology, with 42,202 services from 327 clinicians. Next are Physical Medicine and Rehabilitation, Independent Diagnostic Testing Facility (IDTF), Pediatric Medicine.

CPT 95861

Needle measurement of electrical activity in arm or leg muscles, 2 extremities

$80.08Medicare-allowed amount per service, averaged across 51,162 services

Providers submitted

$1763.92

Asking price, not received

Medicare allowed

$80.08

The fee schedule figure

Medicare paid

$63.30

Balance is patient coinsurance

Providers submitted an average of $1763.92 for this code and Medicare allowed $80.08 — 22.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $63.30 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $102.61
Hospital / facility: $78.92

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 2,503 services were billed in an office setting and 48,659 in a facility.

Services: 51,162
Beneficiaries: 50,280
Providers billing it: 397
Total allowed: $4,097,053

What Medicare pays for CPT 95861

Across 51,162 services billed by 397 providers to 50,280 beneficiaries, Medicare allowed an average of $80.08 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95861

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	42,202	41,558	$80.02	327
Physical Medicine and Rehabilitation	3,144	3,060	$76.52	26
Independent Diagnostic Testing Facility (IDTF)	1,732	1,670	$82.26	4
Pediatric Medicine	588	576	$82.07	1
Neurosurgery	565	558	$78.23	8
Audiologist	516	510	$80.95	1
Osteopathic Manipulative Medicine	414	409	$86.39	2
General Practice	353	349	$82.04	1
Anesthesiology	329	319	$83.58	3
Sleep Medicine	277	265	$78.06	2
Orthopedic Surgery	262	244	$89.84	6
Psychiatry	181	180	$77.70	1
Neuropsychiatry	163	162	$83.05	5
Pain Management	126	123	$100.39	2
Otolaryngology	116	107	$80.35	1

95861 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	8,772	$78.76	$62.96	54
California	8,463	$85.30	$62.68	64
Florida	3,838	$83.58	$65.71	22
New York	3,010	$86.98	$62.45	40
Ohio	2,287	$74.37	$61.56	11
Colorado	2,143	$77.42	$61.62	11
Louisiana	1,938	$72.12	$61.77	11
Nevada	1,914	$78.50	$62.26	7
Arizona	1,874	$79.88	$65.26	16
Georgia	1,818	$76.79	$62.20	15
Pennsylvania	1,675	$77.38	$62.41	21
Maryland	1,322	$76.48	$61.44	9
North Carolina	1,275	$76.42	$61.77	12
Virginia	1,102	$79.32	$61.77	6
New Jersey	1,100	$80.29	$61.87	6
Utah	989	$79.43	$61.61	6
Wisconsin	985	$75.12	$61.69	3
Connecticut	901	$81.73	$61.74	4
Illinois	717	$80.47	$61.61	13
Washington	561	$80.53	$61.19	9
Puerto Rico	512	$75.60	$61.94	1
Michigan	501	$75.71	$61.75	8
Tennessee	480	$84.70	$61.78	6
Kansas	433	$75.06	$61.89	4
Massachusetts	379	$84.52	$61.95	4
District of Columbia	328	$79.31	$61.07	1
Minnesota	293	$80.32	$64.03	5
AE	202	$80.06	$61.93	1
Arkansas	182	$73.12	$61.70	1
Delaware	171	$77.90	$61.97	1
Oregon	144	$79.61	$61.96	3
Oklahoma	120	$73.59	$60.15	3
Alaska	118	$95.45	$62.16	1
Rhode Island	114	$84.26	$62.11	1
South Carolina	107	$75.31	$61.94	3
Missouri	83	$78.50	$61.34	2
New Mexico	56	$75.68	$61.83	1
Nebraska	55	$76.18	$62.26	1
New Hampshire	53	$78.37	$61.98	3
Indiana	49	$75.13	$61.91	3
Idaho	36	$74.07	$61.62	1
Maine	22	$74.85	$61.92	1
Iowa	21	$74.23	$61.87	1
Mississippi	19	$68.06	$61.79	1

Related codes

95886Needle measurement of electrical activity in arm or leg muscles$86.76
95816Measurement of brain wave activity (eeg)$227.96
95811Sleep study in sleep lab$314.61
95810Sleep study in sleep lab (6 years or older)$309.74
95800Sleep study including heart rate$117.17
95819Measurement of brain wave activity (eeg)$239.95
95885Needle measurement of electrical activity in arm or leg muscles$46.74
95806Sleep study including heart rate$54.06
95874Needle measurement of electrical activity in muscle$53.46
95870Needle measurement of electrical activity in arm$19.70
95813Measurement of brain wave activity (eeg)$202.49
95812Measurement of brain wave activity (eeg)$191.83

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.