CPT 95907
Global XXX ActiveNvr cndj tst 1-2 studies
CPT 95907 Billing & Documentation Guide
CPT code 95907 (Nvr cndj tst 1-2 studies) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.98, a non-facility practice expense RVU of 1.79, and a malpractice RVU of 0.05, a total non-facility RVU of 2.82 and facility RVU of 2.82. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $97.23, though rates vary from $84.95 to $123.44 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95907, 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 95907 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 95907 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 95907
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice Expense RVU | 1.79 | 1.79 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 2.82 | 2.82 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95907
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 | $105.56 | $105.56 | $99.71 - $123.44 | 29 |
| Florida | $95.97 | $95.97 | $92.4 - $99.2 | 3 |
| Georgia | $91.82 | $91.82 | $88.05 - $95.58 | 2 |
| Illinois | $93.81 | $93.81 | $89.93 - $97.32 | 4 |
| Michigan | $91.22 | $91.22 | $89.2 - $93.24 | 2 |
| North Carolina | $89.58 | $89.58 | $89.58 - $89.58 | 1 |
| New York | $103.25 | $103.25 | $90.71 - $109.02 | 5 |
| Ohio | $89 | $89 | $89 - $89 | 1 |
| Pennsylvania | $93.38 | $93.38 | $89.2 - $97.55 | 2 |
| Texas | $93.33 | $93.33 | $88.69 - $97.53 | 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 95907
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95907 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 |
| 76883 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 95905 | Column 1 (primary), can be billed with modifier | Yes | 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 |
Frequently Asked Questions, CPT 95907
What does CPT code 95907 mean? +
CPT code 95907 represents: Nvr cndj tst 1-2 studies. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95907? +
The 2026 Medicare national average non-facility payment for CPT 95907 is $97.23. Rates range from $84.95 to $123.44 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95907? +
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 95907? +
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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