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95836 Ecog impltd brn npgt <30 d

What 95836 is

CMS fee schedule short descriptor: Ecog impltd brn npgt <30 d.

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 95836 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.931.120.163.21$107.22
Facility (hospital, ASC)1.930.560.162.65$88.51

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.

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Medically Unlikely Edit (MUE)

Medicare caps 95836 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 95836? These codes are bundled into it

95836 is a Column 1 code in 21 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 codeShort descriptionModifier indicator
0733TRem r-t mtn nrehab ther sply0 - no modifier bypassCheck pair
0734TRem r-t mtn nrehab tx mgmt0 - no modifier bypassCheck pair
0858TExt trnscranl mag stimj meas0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
95824Eeg cerebral death only0 - no modifier bypassCheck pair
95957Eeg digital analysis0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
98975Rtm 1st set-up&pt educaj eqp0 - no modifier bypassCheck pair
98976Rtm dev sply resp sys 16-30d0 - no modifier bypassCheck pair
98977Rtm dev sply mscskl 16-30 d0 - no modifier bypassCheck pair
98980Rtm tx mgmt 1st 20 min0 - no modifier bypassCheck pair
98981Rtm tx mgmt ea addl 20 min0 - no modifier bypassCheck pair
99091Collj & interpj data ea 30 d0 - no modifier bypassCheck pair
99453Rem mntr physiol param setup0 - no modifier bypassCheck pair
99454Rem mntr physiol param 16-300 - no modifier bypassCheck pair
99457Rpm tx mgmt 1st 20 min0 - no modifier bypassCheck pair
99458Rpm tx mgmt ea addl 20 min0 - no modifier bypassCheck pair
99473Self-meas bp pt educaj/train0 - no modifier bypassCheck pair
99474Self-meas bp 2 readg bid 30d0 - no modifier bypassCheck pair
G0250Md inr test revie inter mgmt1 - modifier may bypassCheck pair

95836 is bundled into these codes

95836 appears as a Column 2 code in 13 active edits. Reported with one of these Column 1 codes on the same date of service, 95836 is the code that denies.

Column 1 codeShort descriptionModifier indicator
95705Eeg w/o vid 2-12 hr unmntr0Check pair
95706Eeg wo vid 2-12hr intmt mntr0Check pair
95707Eeg w/o vid 2-12hr cont mntr0Check pair
95711Veeg 2-12 hr unmonitored0Check pair
95712Veeg 2-12 hr intmt mntr0Check pair
95713Veeg 2-12 hr cont mntr0Check pair
95717Eeg phys/qhp 2-12 hr w/o vid0Check pair
95718Eeg phys/qhp 2-12 hr w/veeg0Check pair
95812Eeg 41-60 minutes0Check pair
95813Eeg extnd mntr 61-119 min0Check pair
95816Eeg awake and drowsy0Check pair
95819Eeg awake and asleep0Check pair
95822Eeg coma or sleep only0Check 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.