95857 Cholinesterase challenge
What 95857 is
CMS fee schedule short descriptor: Cholinesterase challenge.
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 95857 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.52 | 1.46 | 0.04 | 2.02 | $67.47 |
| Facility (hospital, ASC) | 0.52 | 0.15 | 0.04 | 0.71 | $23.71 |
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 95857 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 95857? These codes are bundled into it
95857 is a Column 1 code in 14 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 | |
|---|---|---|---|
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
36000 | Place needle in vein | 1 - modifier may bypass | Check pair |
36410 | Vnpnxr 3yr/> phy/qhp dx/ther | 1 - modifier may 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 |
96360 | Hydration iv infusion init | 1 - modifier may bypass | Check pair |
96365 | Ther/proph/diag iv inf init | 1 - modifier may bypass | Check pair |
96372 | Ther/proph/diag inj sc/im | 1 - modifier may bypass | Check pair |
96374 | Ther/proph/diag inj iv push | 1 - modifier may bypass | Check pair |
96375 | Tx/pro/dx inj new drug addon | 1 - modifier may bypass | Check pair |
96376 | Tx/pro/dx inj same drug adon | 1 - modifier may bypass | Check pair |
96377 | Applicaton on-body injector | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | 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.