95872 Ndl emg single fiber eltrd
What 95872 is
CMS fee schedule short descriptor: Ndl emg single fiber eltrd.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 95872 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 2.81 | 3.48 | 0.16 | 6.45 | $215.44 |
| Facility (hospital, ASC) | 2.81 | 3.48 | 0.16 | 6.45 | $215.44 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 95872 at 4 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 95872? These codes are bundled into it
95872 is a Column 1 code in 9 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99446 | Ntrprof ph1/ntrnet/ehr 5-10 | 0 - no modifier bypass | Check pair |
99447 | Ntrprof ph1/ntrnet/ehr 11-20 | 0 - no modifier bypass | Check pair |
99448 | Ntrprof ph1/ntrnet/ehr 21-30 | 0 - no modifier bypass | Check pair |
99449 | Ntrprof ph1/ntrnet/ehr 31/> | 0 - no modifier bypass | Check pair |
99451 | Ntrprof ph1/ntrnet/ehr 5/> | 0 - no modifier bypass | Check pair |
99452 | Ntrprof ph1/ntrnet/ehr rfrl | 0 - no modifier bypass | Check pair |
95872 is bundled into these codes
95872 appears as a Column 2 code in 12 active edits. Reported with one of these Column 1 codes on the same date of service, 95872 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
90912 | Bfb training 1st 15 min | 1 | Check pair |
90913 | Bfb training ea addl 15 min | 1 | Check pair |
95782 | Polysom <6 yrs 4/> paramtrs | 1 | Check pair |
95808 | Polysom any age 1-3> param | 1 | Check pair |
95810 | Polysom 6/> yrs 4/> param | 1 | Check pair |
95940 | Ionm in operatng room 15 min | 1 | Check pair |
96002 | Dynamic surface emg | 0 | Check pair |
96004 | Phys review of motion tests | 1 | Check pair |
G0398 | Home sleep test/type 2 porta | 1 | Check pair |
G0399 | Home sleep test/type 3 porta | 1 | Check pair |
G0400 | Home sleep test/type 4 porta | 1 | Check pair |
G0453 | Cont intraop neuro monitor | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.