CPT 95723
Global XXX ActiveEeg phy/qhp>60<84 hr w/o vid
CPT 95723 Billing & Documentation Guide
CPT code 95723 (Eeg phy/qhp>60<84 hr w/o vid) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4.75, a non-facility practice expense RVU of 2.81, and a malpractice RVU of 0.36, a total non-facility RVU of 7.92 and facility RVU of 6.44. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $270.14, though rates vary from $245.47 to $344.56 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95723, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 95723 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95723 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 95723
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.75 | 4.75 |
| Practice Expense RVU | 2.81 | 1.33 |
| Malpractice RVU | 0.36 | 0.36 |
| Total RVU | 7.92 | 6.44 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95723
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $281.92 | $223.42 | $270.66 - $317.89 | 29 |
| Florida | $276.23 | $226.63 | $266.45 - $286.77 | 3 |
| Georgia | $262.82 | $215.66 | $256.71 - $268.93 | 2 |
| Illinois | $272.88 | $225.11 | $263.14 - $281.69 | 4 |
| Michigan | $263.71 | $217.3 | $257.92 - $269.5 | 2 |
| North Carolina | $253.91 | $207.78 | $253.91 - $253.91 | 1 |
| New York | $287.23 | $232.08 | $256.27 - $302.73 | 5 |
| Ohio | $256.47 | $211.33 | $256.47 - $256.47 | 1 |
| Pennsylvania | $264.87 | $216.45 | $256.18 - $273.56 | 2 |
| Texas | $263.1 | $214.43 | $255.23 - $269.67 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 95723
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95723 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0733T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95717 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95718 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95719 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95720 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95721 | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 95722 | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 95812 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95723
What does CPT code 95723 mean? +
CPT code 95723 represents: Eeg phy/qhp>60<84 hr w/o vid. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95723? +
The 2026 Medicare national average non-facility payment for CPT 95723 is $270.14. Rates range from $245.47 to $344.56 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95723? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 95723? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team