How much does Medicare pay for CPT 95874?

Medicare allowed an average of $53.46 per service and paid $41.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $186.88, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95874?

Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle. It was billed 78,119 times to 32,078 Medicare beneficiaries by 1,181 providers in 2024.

Does 95874 pay differently in an office than a hospital?

Yes. The allowed amount averaged $65.15 in an office setting and $18.70 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 95874 most?

Neurology, with 48,869 services from 747 clinicians. Next are Physical Medicine and Rehabilitation, Nurse Practitioner, Neuropsychiatry.

CPT 95874

Needle measurement of electrical activity in muscle with injection of chemical for paralysis of nerve muscle

$53.46Medicare-allowed amount per service, averaged across 78,119 services

Providers submitted

$186.88

Asking price, not received

Medicare allowed

$53.46

The fee schedule figure

Medicare paid

$41.81

Balance is patient coinsurance

Providers submitted an average of $186.88 for this code and Medicare allowed $53.46 — 3.5× 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 $41.81 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $65.15
Hospital / facility: $18.70

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. 58,471 services were billed in an office setting and 19,648 in a facility.

Services: 78,119
Beneficiaries: 32,078
Providers billing it: 1,181
Total allowed: $4,176,242

What Medicare pays for CPT 95874

Across 78,119 services billed by 1,181 providers to 32,078 beneficiaries, Medicare allowed an average of $53.46 per service. That is 2.4 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 95874

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	48,869	19,499	$55.55	747
Physical Medicine and Rehabilitation	26,374	11,350	$50.63	381
Nurse Practitioner	770	324	$35.07	18
Neuropsychiatry	444	169	$37.77	7
Physician Assistant	381	183	$35.08	9
Interventional Pain Management	303	139	$70.25	6
Pain Management	216	94	$75.43	3
Neurosurgery	154	55	$21.02	2
General Practice	129	34	$101.33	1
Internal Medicine	121	46	$17.83	1
Psychiatry	113	67	$42.48	1
Family Practice	92	31	$65.59	1
Plastic and Reconstructive Surgery	61	37	$16.90	1
Pediatric Medicine	56	28	$18.55	1
Otolaryngology	36	22	$17.30	2

95874 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
California	6,277	$61.99	$42.06	89
Florida	5,378	$66.21	$53.33	76
New York	4,785	$67.21	$47.36	70
Massachusetts	3,856	$49.74	$35.64	40
Pennsylvania	3,826	$56.13	$44.87	53
Illinois	3,695	$52.93	$41.78	60
Texas	3,294	$60.25	$48.30	52
Minnesota	3,248	$56.22	$43.16	47
Ohio	3,206	$46.36	$39.07	56
Wisconsin	2,588	$35.38	$28.70	30
Washington	2,540	$56.78	$42.00	40
North Carolina	2,395	$53.50	$43.84	33
Missouri	2,326	$54.01	$43.94	33
Virginia	2,233	$43.37	$32.16	32
Colorado	2,127	$63.37	$48.75	34
Michigan	1,600	$42.60	$34.10	33
Connecticut	1,512	$67.87	$49.25	19
New Jersey	1,486	$62.98	$45.26	23
Georgia	1,466	$48.18	$42.36	28
Tennessee	1,360	$47.02	$39.39	24
South Carolina	1,290	$48.98	$41.23	21
Indiana	1,288	$61.70	$53.17	26
Arizona	1,279	$63.58	$50.58	22
Mississippi	1,221	$34.88	$30.96	8
Iowa	1,181	$34.98	$29.24	17
Kansas	1,163	$42.11	$34.04	13
Kentucky	1,146	$27.66	$23.05	17
Nebraska	945	$32.21	$26.01	14
Maryland	915	$54.85	$39.91	18
District of Columbia	707	$80.80	$52.77	10
Alabama	688	$59.90	$53.30	11
New Hampshire	639	$21.67	$16.16	10
Montana	606	$43.39	$34.23	11
North Dakota	499	$24.09	$18.80	9
South Dakota	472	$52.52	$42.23	7
Louisiana	463	$50.12	$43.52	12
Nevada	463	$45.89	$36.23	8
Maine	450	$25.32	$19.27	7
West Virginia	430	$32.91	$27.06	8
Arkansas	408	$29.15	$24.82	6
Oregon	402	$62.65	$50.05	10
Oklahoma	392	$68.50	$56.84	6
Delaware	386	$37.32	$30.20	6
Utah	355	$42.85	$35.65	7
New Mexico	303	$38.96	$33.34	6
Idaho	247	$35.30	$31.12	5
Rhode Island	244	$60.38	$47.39	5
Vermont	191	$18.43	$14.16	4
Hawaii	124	$75.16	$53.69	4
Alaska	24	$74.73	$50.57	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
95861Needle measurement of electrical activity in arm or leg muscles$80.08
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.