Billing code 95937: NMJ testingMedicare rate & RVUs in Delaware
Reports stimulation testing of a nerve to evaluate neuromuscular transmission, often during a diagnostic workup for suspected myasthenia gravis or Lambert-Eaton syndrome.
Medicare pays $105.51 for 95937 in the office in Delaware (Delaware). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 95937 covers
This test evaluates how reliably a nerve signal activates muscle. A neurologist or trained neurodiagnostic staff member may perform repetitive nerve stimulation or another neuromuscular transmission method, with physician interpretation. It is commonly part of an outpatient or hospital evaluation for suspected myasthenia gravis, Lambert-Eaton syndrome, or another disorder affecting transmission between nerve and muscle. Repetitive stimulation may assess changes in the muscle response across repeated stimuli; testing protocols can also examine responses after exercise or facilitation.
Report the service for each nerve tested, using one method for that nerve. Documentation should identify the nerve and method, describe the recorded responses and relevant stimulation conditions, and support the interpretation. CMS recognizes separate professional and technical components: report modifier 26 for the interpretation or modifier TC for the equipment and staff; without either modifier, the claim represents the global service. The professional and technical modifiers are separately priced in the physician fee schedule.
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.
95937 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $105.51 | Unavailable |
How the 95937 rate is calculated
Each of 95937’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 95937
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.63Practice expense 2.52Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95937
The CMS indicators that decide how 95937 is paid alongside other services.
CMS payment indicators · 95937
NMJ testing
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95937 without 26 · national office
$106.55
NMJ testing
95937-26 · Professional component
$34.07
Pays only the interpretation and report.
95937 compared with similar codes
Compare codes
95937 vs 95912 vs 95933 vs 95886: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95912Nerve conduction study
- Use 95912 for the specified nerve conduction study count. Use 95937 for testing directed at neuromuscular transmission, such as repetitive stimulation.
- 95933Blink reflex
- 95933 reports blink reflex testing, a reflex pathway assessment. It does not represent repetitive stimulation testing of neuromuscular transmission.
- 95886Needle EMG add-on
- 95886 reports needle EMG examination of muscle. It evaluates muscle electrical activity rather than the nerve-to-muscle transmission assessed by 95937.
95937 billing questions
How is this different from a nerve conduction study?
This code evaluates neuromuscular transmission using a stimulation method such as repetitive nerve stimulation. Nerve conduction study codes are selected by the number of qualifying nerve conduction studies performed.
Can this be reported with nerve conduction studies or needle EMG?
They may be reported together when each service is performed and documented as a distinct part of the diagnostic evaluation. The record should support the testing performed under each code.
When should modifier 26 or TC be used?
Use modifier 26 for the physician's interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the code represents the global service.
How are units determined?
Report one unit for each nerve tested with one method. The documentation should identify each nerve and the method used.
What documentation supports the service?
Document the clinical indication, nerve tested, stimulation method and conditions, recorded responses, and interpretation. For repetitive stimulation, include the response pattern across stimuli and any relevant exercise or facilitation protocol.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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