CPT 51784: EMG of Anal or Urethral Sphincter Muscles
Medicare pays $46 and commercial payers pay $156 on average nationally for this procedure.
CPT code 51784 represents an electromyography (EMG) test that measures electrical activity in the anal or urethral sphincter muscles, used to assess neuromuscular function of the pelvic floor; service type: diagnostic electrodiagnostic study; typical site of service: outpatient clinic, urology or colorectal procedure suite, or specialized neurophysiology lab.
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National Reimbursement Benchmarks
Medicare’s national mean rate of $45.8 sits well below BUCA’s average commercial mean of $155.6, highlighting a substantial gap between federal reimbursement and this commercial benchmark. The difference of $109.8 in mean rates underscores that Medicare is closer to the lower end of the payer spectrum, while BUCA represents a higher-cost commercial average for CPT 51784.
Examining dispersion using the interquartile spread (P75 minus P25) highlights variation across payers: Blue Cross Blue Shield’s spread is $61.0 (P75 $217.9 minus P25 $157.1), UnitedHealth Group’s spread is $80.0 (P75 $135.8 minus P25 $53.8), Aetna’s spread is $64.0, Cigna’s spread is $92.1, and BUCA’s spread is $69.1. Cigna shows the widest IQR at $92.1, indicating the largest mid‑range variability, while Blue Cross Blue Shield is relatively tightest at $61.0.