Locality

or ZIP

Show values as

Switch every figure between Medicare dollars and work RVUs.

Conversion factor

Component

95866

Needle emg hemidiaphragm

Add to my model

Code typePrimary

Payment statusActive (A)

Global periodNone

Pricing with Related Codes

Line

Qty

Global fee

Pro fee

Primary95866Needle emg hemidiaphragm

$136.28

Add-on95940Ionm in operatng room 15 min

$26.72/ unit

Add-on95941Ionm remote/>1 pt or per hr

$0.00/ unit

Add-onG0453Cont intraop neuro monitor

$27.39/ unit

Whole procedure · 1.22 wRVU credited

$136.28

How these numbers were computed

status=IThis code is not separately payable under the Physician Fee Schedule (status I) — amounts shown are $0.

RVU Breakdown

Component

Office

Facility

Work

1.22

Practice expense

2.81

Malpractice

0.05

Total RVU

4.08

Payment Policy & Modifiers

Allowed adjustments

Bilateral -50100% each

The usual 150% cap does not apply — each side is paid in full.

Assistant surgeon -80/81/8216% · documented

Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.

Prof / tech split -26 / -TCSplit

Has professional (-26) and technical (-TC) components, each priced separately.

Not applicable to this code

Multiple procedure Co-surgeon -62Team surgeon -66

In plain English

Office vs. facility

Where the service happens. In your own clinic (office), Medicare also pays you for the room, staff and supplies — so it's higher. In a hospital or ASC, the facility bills that part separately.

wRVU

Work Relative Value Units — the physician-effort share of a code. Most employment contracts pay a set dollar amount per wRVU, independent of Medicare's rate.

Add-on codes

Billed only alongside a primary. 95940 adds each extra unit — the stepper adds them to the whole-procedure total.

Conversion factor

The dollars-per-RVU Medicare multiplies by. Set once, it flows through every figure on this page. The QP rate applies to clinicians who qualify as Advanced APM participants — a small annual boost.

GPCI

Geographic Practice Cost Index — adjusts the work, practice-expense and malpractice RVUs for your locality's cost of living before they're multiplied by the conversion factor.

How payment is computed

Each RVU is scaled by your locality's GPCI, summed, then multiplied by the conversion factor:

(work·wGPCI
+ PE·peGPCI
+ MP·mpGPCI) × CF

This code's Global fee

(1.22·1.000
+ 2.81·1.000
+ 0.05·1.000) × $33.40 = $136.28

Full methodology — how we apply CMS's rules →