95726 Eeg phy/qhp>84 hr w/veeg
What 95726 is
CMS fee schedule short descriptor: Eeg phy/qhp>84 hr w/veeg.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 95726 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 7.58 | 4.59 | 0.60 | 12.77 | $426.53 |
| Facility (hospital, ASC) | 7.58 | 2.17 | 0.60 | 10.35 | $345.70 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 95726 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 95726? These codes are bundled into it
95726 is a Column 1 code in 29 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0733T | Rem r-t mtn nrehab ther sply | 0 - no modifier bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
95717 | Eeg phys/qhp 2-12 hr w/o vid | 0 - no modifier bypass | Check pair |
95718 | Eeg phys/qhp 2-12 hr w/veeg | 0 - no modifier bypass | Check pair |
95719 | Eeg phys/qhp ea incr w/o vid | 0 - no modifier bypass | Check pair |
95720 | Eeg phy/qhp ea incr w/veeg | 0 - no modifier bypass | Check pair |
95721 | Eeg phy/qhp>36<60 hr w/o vid | 0 - no modifier bypass | Check pair |
95722 | Eeg phy/qhp>36<60 hr w/veeg | 0 - no modifier bypass | Check pair |
95723 | Eeg phy/qhp>60<84 hr w/o vid | 0 - no modifier bypass | Check pair |
95724 | Eeg phy/qhp>60<84 hr w/veeg | 0 - no modifier bypass | Check pair |
95725 | Eeg phy/qhp>84 hr w/o vid | 0 - no modifier bypass | Check pair |
95812 | Eeg 41-60 minutes | 0 - no modifier bypass | Check pair |
95813 | Eeg extnd mntr 61-119 min | 0 - no modifier bypass | Check pair |
95816 | Eeg awake and drowsy | 0 - no modifier bypass | Check pair |
95819 | Eeg awake and asleep | 0 - no modifier bypass | Check pair |
95822 | Eeg coma or sleep only | 0 - no modifier bypass | Check pair |
95824 | Eeg cerebral death only | 1 - modifier may bypass | Check pair |
95940 | Ionm in operatng room 15 min | 1 - modifier may bypass | Check pair |
95955 | Eeg during surgery | 1 - modifier may bypass | Check pair |
95957 | Eeg digital analysis | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
98975 | Rtm 1st set-up&pt educaj eqp | 0 - no modifier bypass | Check pair |
98976 | Rtm dev sply resp sys 16-30d | 0 - no modifier bypass | Check pair |
98977 | Rtm dev sply mscskl 16-30 d | 0 - no modifier bypass | Check pair |
99453 | Rem mntr physiol param setup | 0 - no modifier bypass | Check pair |
99454 | Rem mntr physiol param 16-30 | 0 - no modifier bypass | Check pair |
G0250 | Md inr test revie inter mgmt | 1 - modifier may bypass | Check pair |
G0453 | Cont intraop neuro monitor | 1 - modifier may bypass | Check pair |
95726 is bundled into these codes
95726 appears as a Column 2 code in 281 active edits. Reported with one of these Column 1 codes on the same date of service, 95726 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
00100 | Anes px salivary gland w/bx | 0 | Check pair |
00102 | Anes px plstc rpr cleft lip | 0 | Check pair |
00103 | Anes rcnstv px eyelid | 0 | Check pair |
00104 | Anes electroconvulsive ther | 0 | Check pair |
00120 | Anes px ear w/bx nos | 0 | Check pair |
00124 | Anes px ear otoscopy | 0 | Check pair |
00126 | Anes px ear tympanotomy | 0 | Check pair |
00140 | Anes procedures on eye nos | 0 | Check pair |
00142 | Anes px on eye lens surgery | 0 | Check pair |
00144 | Anes px eye corneal trnspl | 0 | Check pair |
00145 | Anes px eye vitreortnl surg | 0 | Check pair |
00147 | Anes px on eye iridectomy | 0 | Check pair |
00148 | Anes px eye ophthalmoscopy | 0 | Check pair |
00160 | Anes px nose&sinus nos | 0 | Check pair |
00162 | Anes px nose&sinus rad surg | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.