$113.73
Use 95857 for a cholinesterase inhibitor challenge of each muscle tested. Use 95937 for neuromuscular junction testing by electrical stimulation.
On this page
CMS RVU26D · Effective 2026-10-01
95857 Cholinesterase challenge Medicare reimbursement rates in Connecticut
Reports a pharmacologic cholinesterase inhibitor challenge of an individual muscle, commonly used during evaluation of suspected myasthenia gravis. Compare 95857 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95857 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$71.85
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$24.73
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Electrodiagnostic testing
About 95857: Cholinesterase inhibitor muscle challenge
Reports a pharmacologic cholinesterase inhibitor challenge of an individual muscle, commonly used during evaluation of suspected myasthenia gravis.
This electrodiagnostic service assesses a selected muscle’s response to a cholinesterase inhibitor, such as edrophonium, by comparing its function before and after the challenge. Neurologists and other clinicians trained in electrodiagnostic testing may use it when evaluating fatigable weakness, ptosis, or diplopia suggestive of a neuromuscular junction disorder. The result is interpreted in the context of the patient’s examination and other diagnostic findings.
Report the service for each muscle tested, rather than for each drug dose or the overall visit. Documentation should identify the muscle, the pre- and post-challenge findings, and the clinical reason for testing. Medicare values the service under the Physician Fee Schedule using physician work, practice expense, and malpractice components; practice expense valuation differs between office and facility settings.
Where the value comes from
- Work RVU0.52 · 26%
- Practice expense (office) RVU1.46 · 72%
- Malpractice RVU0.04 · 2%
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
95857 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$227.39
95872 reports single-fiber EMG using a specialized electrode; 95857 reports the muscle’s response to a pharmacologic challenge.
$127.22
95860 reports needle EMG of one extremity. It evaluates electrical activity in muscles, rather than a cholinesterase inhibitor response.
Compare 95857 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$71.85
Facility
$24.73
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95857 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
12,575
- Code
- 95857
- Physician work
- 0.52
- Practice expense
- 1.46
- Malpractice
- 0.04
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.52 | × 1.020 | 0.5304 |
| Practice expense | 1.46 | × 1.077 | 1.5724 |
| Malpractice | 0.04 | × 1.210 | 0.0484 |
| Total RVUs | 2.1512 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$71.85
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.52 | 1.02 |
| Practice expense | 1.46 | 1.077 |
| Malpractice | 0.04 | 1.21 |
(0.52 × 1.02 + 1.46 × 1.077 + 0.04 × 1.21) × $33.4009 = $71.85
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.52 | 1.02 |
| Practice expense | 0.15 | 1.077 |
| Malpractice | 0.04 | 1.21 |
(0.52 × 1.02 + 0.15 × 1.077 + 0.04 × 1.21) × $33.4009 = $24.73
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
95857 billing questions
How is 95857 different from repetitive nerve stimulation?
95857 reports a pharmacologic cholinesterase inhibitor challenge of each muscle tested. Repetitive nerve stimulation is an electrical neuromuscular junction test reported with 95937.
How many units should be reported?
Report by muscle tested, not by medication dose or visit. The record should identify each muscle challenged and its response.
What documentation supports the service?
Document the suspected neuromuscular junction problem, the muscle tested, and the findings before and after the challenge.
Can needle EMG be part of the same evaluation?
Yes. Needle EMG may be performed as a separate electrodiagnostic service when clinically indicated; document the muscles examined and findings for that service independently.
Is a cholinesterase challenge the same as single-fiber EMG?
No. The challenge evaluates a muscle’s response to a cholinesterase inhibitor, while single-fiber EMG evaluates electrical activity using a specialized electrode.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,57295836,,Ecog impltd brn npgt <30 d,A,,1.93,1.12,,0.56,,0.16,3.21,2.65,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,57395851,,Range of motion measurements,A,,0.16,0.61,,0.03,,0.01,0.78,0.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,57495852,,Range of motion measurements,A,,0.11,0.52,,0.03,,0.01,0.64,0.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,57595857,,Cholinesterase challenge,A,,0.52,1.46,,0.15,,0.04,2.02,0.71,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,57695860,,Needle emg 1 extremity,A,,0.94,2.59,,2.59,NA,0.05,3.58,3.58,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,57795860,26,Needle emg 1 extremity,A,,0.94,0.56,,0.56,,0.04,1.54,1.54,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,57895860,TC,Needle emg 1 extremity,A,,0.00,2.03,,2.03,NA,0.01,2.04,2.04,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,6A,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808