CPT 95873
Global ZZZ ActiveGuide nerv destr elec stim
CPT 95873 Billing & Documentation Guide
CPT code 95873 (Guide nerv destr elec stim) is classified under Neurology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.36, a non-facility practice expense RVU of 1.91, and a malpractice RVU of 0.01, a total non-facility RVU of 2.28 and facility RVU of 2.28. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $79.14, though rates vary from $67 to $105.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95873, 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 95873 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95873 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 95873
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.36 | 0.36 |
| Practice Expense RVU | 1.91 | 1.91 |
| Malpractice RVU | 0.01 | 0.01 |
| Total RVU | 2.28 | 2.28 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95873
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 | $88.13 | $88.13 | $82.33 - $105.52 | 29 |
| Florida | $76.68 | $76.68 | $73.52 - $79.28 | 3 |
| Georgia | $73.31 | $73.31 | $69.33 - $77.28 | 2 |
| Illinois | $74.35 | $74.35 | $70.79 - $78.22 | 4 |
| Michigan | $72.4 | $72.4 | $70.65 - $74.15 | 2 |
| North Carolina | $71.76 | $71.76 | $71.76 - $71.76 | 1 |
| New York | $84.22 | $84.22 | $72.87 - $89.27 | 5 |
| Ohio | $70.61 | $70.61 | $70.61 - $70.61 | 1 |
| Pennsylvania | $74.98 | $74.98 | $70.9 - $79.05 | 2 |
| Texas | $75.21 | $75.21 | $70.39 - $79.84 | 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 95873
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95873 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99446 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99447 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99448 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99449 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99451 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99452 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 64451 | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95873
What does CPT code 95873 mean? +
CPT code 95873 represents: Guide nerv destr elec stim. It's in the Neurology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 95873? +
The 2026 Medicare national average non-facility payment for CPT 95873 is $79.14. Rates range from $67 to $105.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95873? +
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 95873? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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