CPT 95957
Global XXX ActiveEeg digital analysis
CPT 95957 Billing & Documentation Guide
CPT code 95957 (Eeg digital analysis) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.93, a non-facility practice expense RVU of 7.24, and a malpractice RVU of 0.11, a total non-facility RVU of 9.28 and facility RVU of 9.28. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $321.3, though rates vary from $274.08 to $422.23 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95957, 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 95957 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 95957 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 95957
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.93 | 1.93 |
| Practice Expense RVU | 7.24 | 7.24 |
| Malpractice RVU | 0.11 | 0.11 |
| Total RVU | 9.28 | 9.28 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95957
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 | $354.91 | $354.91 | $332.57 - $422.23 | 29 |
| Florida | $314.24 | $314.24 | $301.17 - $325.49 | 3 |
| Georgia | $299.66 | $299.66 | $284.55 - $314.76 | 2 |
| Illinois | $305.37 | $305.37 | $290.99 - $319.78 | 4 |
| Michigan | $296.71 | $296.71 | $289.4 - $304.02 | 2 |
| North Carolina | $292.43 | $292.43 | $292.43 - $292.43 | 1 |
| New York | $342.29 | $342.29 | $296.78 - $362.94 | 5 |
| Ohio | $288.95 | $288.95 | $288.95 - $288.95 | 1 |
| Pennsylvania | $305.84 | $305.84 | $289.93 - $321.74 | 2 |
| Texas | $306.31 | $306.31 | $287.94 - $323.7 | 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 95957
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95957 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0858T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 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 |
| 95700 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 95705 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95706 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95707 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95708 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 95709 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95710 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95957
What does CPT code 95957 mean? +
CPT code 95957 represents: Eeg digital analysis. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95957? +
The 2026 Medicare national average non-facility payment for CPT 95957 is $321.3. Rates range from $274.08 to $422.23 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95957? +
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 95957? +
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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