Medicine · 95870

Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study

What Medicare pays for 95870, what providers bill, and how the price varies across 38 states, drawn from CMS 2023 claims data.

95870 · the short answer

For needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study, Medicare pays about $16.05 while providers bill $876.87 on average, a 54.6× markup, one of the steepest markups in the catalog. State-level Medicare rates range 377% from lowest to highest.

Medicare pays
$16.05
Providers bill
$876.87
Markup
54.6×
Markup percentile
100th

Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.

Medicare Payment (avg)
$16.05
What Medicare actually pays
Billed Charge (avg)
$876.87
What providers submit
Markup
54.6x
5363% above Medicare rate
53.8K
Total Services
27.8K
Beneficiaries
689
Providers
38
States with Data

Price Range Across States

Lowest State Avg
$13.33
Indiana
Highest State Avg
$63.54
Missouri

What You Might Pay

Est. Commercial Insurance
$43.64
Range: $30.55 – $61.10
Est. Cash / Self-Pay
$256.36
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Medicine procedures average 2.15x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Where this markup sits nationally

Markup (billed ÷ Medicare) across 8,901 procedures with a meaningful Medicare rate

55 Among the most affordable more affordable than 99% of 8,901 procedures

1–2: 466 procedures (5%). Below this entry. 2–3: 681 procedures (8%). Below this entry. 3–4: 845 procedures (9%). Below this entry. 4–5: 1,308 procedures (15%). Below this entry. 5–6: 1,725 procedures (19%). Below this entry. 6–7: 1,217 procedures (14%). Below this entry. 7–8: 801 procedures (9%). Below this entry. 8–9: 541 procedures (6%). Below this entry. 9–10: 351 procedures (4%). Below this entry. 10–11: 246 procedures (3%). Below this entry. 11–12: 151 procedures (2%). Below this entry. 12–13: 175 procedures (2%). Below this entry. 13–14: 140 procedures (2%). Below this entry. 14–15: 40 procedures (0%). Below this entry. 15–16: 39 procedures (0%). Below this entry. 16–17: 26 procedures (0%). Below this entry. 17–18: 25 procedures (0%). Below this entry. 18–19: 21 procedures (0%). Below this entry. 19–20: 12 procedures (0%). Below this entry. 20–21: 16 procedures (0%). Below this entry. 21–22: 13 procedures (0%). Below this entry. 22–23: 8 procedures (0%). Below this entry. 23–24: 9 procedures (0%). Below this entry. 24–25: 4 procedures (0%). Below this entry. 25–26: 3 procedures (0%). Below this entry. 26–27: 3 procedures (0%). Below this entry. 27–28: 4 procedures (0%). Below this entry. 28–29: 3 procedures (0%). Below this entry. 29–30: 2 procedures (0%). Below this entry. 30–31: 26 procedures (0%). This entry sits in this band. this procedure 1 31 × markup, bucketed by value

Each bar is a band; taller bars hold more procedures. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners · 2023

Prices by State

State Medicare Payment Billed Charge
Missouri $63.54 $266.59
Alaska $20.33 $74.21
Florida $17.85 $739.60
New York $17.55 $1,105.68
Pennsylvania $17.53 $1,216.62
Nevada $16.84 $541.48
District of Columbia $16.47 $504.33
Massachusetts $16.41 $313.69
California $16.31 $580.90
Texas $16.31 $1,508.94
Washington $16.22 $1,036.37
Minnesota $16.13 $345.00
Illinois $16.03 $797.06
Connecticut $15.91 $1,005.32
Tennessee $15.75 $698.97
Oregon $15.69 $88.59
New Jersey $15.66 $1,216.39
Michigan $15.61 $488.08
Hawaii $15.56 $377.00
Maryland $15.55 $358.20
Colorado $15.44 $1,051.59
Delaware $15.21 $377.00
Utah $15.13 $3,143.79
Georgia $15.09 $1,298.89
Virginia $15.03 $775.23
Arizona $14.97 $1,069.83
Nebraska $14.78 $181.85
North Carolina $14.67 $420.36
Louisiana $14.64 $93.93
New Mexico $14.59 $377.00
South Carolina $14.57 $372.30
Oklahoma $14.55 $586.15
Wisconsin $14.52 $548.01
Arkansas $14.50 $1,330.73
Ohio $14.43 $652.85
Iowa $14.42 $169.31
Kansas $14.40 $309.13
Indiana $13.33 $75.00

What the Data Says About Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study

Across 38 states with reporting providers, CPT code 95870 (Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study) shows a national average Medicare payment of $16.05 against an average billed charge of $876.87. That gap, a 54.6x markup, or 5363% above the Medicare allowed amount, sits among the widest billed-to-paid spreads we track, the kind of chargemaster pricing almost no payer, insured or cash, actually honors in full.

Medicine procedures like this one saw 53.8K services billed to Medicare in 2023 by 689 distinct providers, serving 27.8K unique beneficiaries. State-level variation is significant: Indiana reports the lowest average payment at $13.33, while Missouri reports the highest at $63.54. A 377% spread this wide is typically a GPCI story: practice-expense and malpractice-premium components of the fee formula diverge sharply by locality even though the procedure code never changes.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Medicine category (2.15x), the estimated commercial insurance price lands near $43.64, with self-pay cash discounts commonly bringing the figure closer to $256.36. Within Medicine, Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study ranks #462 of 533 tracked procedures by national average Medicare payment.

What to do with this

If you may have needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study done, these steps turn the numbers above into a real-world cost estimate.

  • Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
  • Compare needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study costs in your state, Medicare rates vary by locality. Browse states
  • Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
  • Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide

Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.

Frequently Asked Questions

How much does Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study cost?

Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study (CPT 95870) shows unusually wide state-to-state pricing: Medicare pays $16.05 on average nationally, but the $13.33-$63.54 range across states spans more than double from cheapest to priciest.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study cost with insurance?

With commercial insurance, needle measurement of electrical activity in arm, leg, trunk or head muscles, limited study costs an estimated $43.64 on average (range: $30.55-$61.10), a moderate premium over Medicare's $16.05. Without insurance, the estimated cash price is $256.36.

Which state has the lowest cost for Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study?

Indiana has by far the lowest average Medicare payment for Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study at $13.33, while Missouri pays more than double at $63.54 - a $50.21 gap.

How many providers perform Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study?

A moderate provider base performs Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study: 689 providers nationally, totaling 53.8K Medicare-billed services (27.8K beneficiaries) across 38 states in 2023.

What is the billed-to-Medicare markup for Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study?

Providers bill 54.6x what Medicare pays for Needle Measurement Of Electrical Activity In Arm, Leg, Trunk Or Head Muscles, Limited Study - one of the steepest markups in the catalog at 5363% above the Medicare rate.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.