How much does Medicare pay for CPT 95870?

Medicare allowed an average of $19.70 per service and paid $15.58 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $934.40, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95870?

Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study. It was billed 45,733 times to 24,370 Medicare beneficiaries by 271 providers in 2024.

Does 95870 pay differently in an office than a hospital?

Yes. The allowed amount averaged $64.61 in an office setting and $19.21 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 95870 most?

Neurology, with 37,659 services from 221 clinicians. Next are Physical Medicine and Rehabilitation, Anesthesiology, Pain Management.

CPT 95870

Needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study

$19.70Medicare-allowed amount per service, averaged across 45,733 services

Providers submitted

$934.40

Asking price, not received

Medicare allowed

$19.70

The fee schedule figure

Medicare paid

$15.58

Balance is patient coinsurance

Providers submitted an average of $934.40 for this code and Medicare allowed $19.70 — 47.4× 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 $15.58 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $64.61
Hospital / facility: $19.21

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. 490 services were billed in an office setting and 45,243 in a facility.

Services: 45,733
Beneficiaries: 24,370
Providers billing it: 271
Total allowed: $900,940

What Medicare pays for CPT 95870

Across 45,733 services billed by 271 providers to 24,370 beneficiaries, Medicare allowed an average of $19.70 per service. That is 1.9 services per beneficiary, so this is a code patients typically receive more than once. 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 95870

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	37,659	19,883	$19.34	221
Physical Medicine and Rehabilitation	3,638	2,071	$19.43	18
Anesthesiology	935	458	$20.38	5
Pain Management	449	208	$20.43	1
Osteopathic Manipulative Medicine	441	215	$19.12	1
Psychiatry	440	225	$18.78	1
Pediatric Medicine	436	224	$20.06	2
Neuropsychiatry	426	348	$19.92	8
Independent Diagnostic Testing Facility (IDTF)	366	228	$58.72	1
General Practice	312	144	$19.96	1
Neurosurgery	297	160	$19.33	6
Sleep Medicine	90	46	$18.46	1
Otolaryngology	66	34	$19.33	1
Orthopedic Surgery	65	28	$19.94	1
Diagnostic Radiology	57	51	$20.09	1

95870 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	6,379	$21.13	$16.96	35
California	6,010	$20.08	$15.00	25
Colorado	3,398	$19.35	$15.05	13
Florida	3,217	$20.43	$15.84	18
North Carolina	2,065	$18.57	$15.02	5
Maryland	1,762	$19.44	$14.97	22
Pennsylvania	1,585	$21.31	$16.83	13
New York	1,559	$20.58	$14.98	14
Ohio	1,384	$18.21	$14.99	8
Kansas	1,380	$18.27	$15.09	4
New Jersey	1,368	$19.61	$14.97	10
Georgia	1,318	$18.84	$15.05	9
Illinois	1,174	$20.60	$15.81	18
Virginia	1,124	$18.75	$14.98	4
Massachusetts	1,112	$20.52	$15.08	5
Nevada	1,095	$19.52	$15.31	7
Louisiana	1,030	$17.16	$15.07	4
Arizona	946	$18.37	$14.90	9
Minnesota	901	$18.98	$15.07	5
Puerto Rico	859	$18.30	$15.11	1
Connecticut	814	$19.91	$15.05	3
Utah	688	$19.04	$15.02	7
Delaware	604	$18.97	$15.09	1
Michigan	564	$18.44	$15.03	7
Wisconsin	550	$18.22	$14.97	2
Washington	482	$19.42	$15.01	4
South Carolina	362	$18.28	$15.08	1
Tennessee	350	$20.92	$15.09	2
Oklahoma	336	$16.84	$14.91	1
Alaska	218	$23.41	$15.09	1
New Mexico	205	$18.44	$14.93	1
District of Columbia	177	$19.34	$15.09	2
Oregon	176	$19.95	$15.13	3
Nebraska	174	$18.39	$15.19	1
AE	129	$18.91	$15.10	1
Missouri	120	$19.08	$15.12	2
Rhode Island	78	$20.51	$15.14	1
Iowa	21	$18.00	$15.06	1
Arkansas	19	$17.70	$15.05	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
95861Needle measurement of electrical activity in arm or leg muscles$80.08
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.