Billing code 95957: EEG analysisMedicare rate & RVUs in Guam
Report digital analysis of EEG data, such as analysis for epileptic spikes, as a distinct service alongside the underlying EEG recording when performed.
Medicare pays $341.54 for 95957 in the office in Guam (Hawaii, Guam). 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 95957 covers
This service covers computer-based analysis of electroencephalographic data, including analysis directed at identifying epileptic spikes. It is used in neurologic evaluations, particularly when clinicians assess seizure activity from EEG recordings. A neurologist or other qualified professional interprets the analytic output; the technical work uses the equipment and staff needed to process the recorded data.
Report 95957 for the digital analysis itself, rather than for acquiring an EEG or merely reviewing its tracing visually. Documentation should identify the EEG data analyzed, the analysis performed, and the findings or clinical interpretation. Modifier 26 represents the professional interpretation, while modifier TC represents the technical service involving equipment and staff. Without either modifier, the claim represents the global service.
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.
95957 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $341.54 | Unavailable |
How the 95957 rate is calculated
Each of 95957’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 · 95957
RVUs × geographic indexes × conversion factor
Work1.93
1.93 RVUs× 1.000 GPCI
Practice expense7.24
7.24 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
9.2800
Conversion factor
$33.4009
Medicare rate
$309.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95957
The CMS indicators that decide how 95957 is paid alongside other services.
CMS payment indicators · 95957
EEG analysis
| 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
95957 without 26 · national office
$309.96
EEG analysis
95957-26 · Professional component
$101.54
Pays only the interpretation and report.
95957 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95816EEG
- 95816 reports an awake and drowsy EEG recording. Choose 95957 for digital analysis of EEG data, not for the recording itself.
- 95819EEG
- 95819 reports an EEG recording that includes awake and asleep states. 95957 describes digital analysis performed on EEG data.
- 95955Intraoperative EEG
- 95955 describes EEG monitoring during surgery. 95957 describes digital analysis of EEG data rather than the intraoperative monitoring service.
95957 billing questions
How is 95957 different from a routine EEG code?
Routine EEG codes describe recording the brain's electrical activity. 95957 describes digital analysis of EEG data, such as analysis for epileptic spikes.
Can 95957 be reported with the EEG recording?
The EEG recording and digital analysis describe distinct work and may be reported for the same study when both services were performed and documented.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service involving equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports the digital analysis?
Record which EEG data were analyzed, the digital analysis performed, and the resulting findings or interpretation. The record should make clear that the service involved analysis, not just EEG acquisition.
Is 95957 the code for EEG monitoring during surgery?
No. 95957 describes digital EEG analysis; 95955 describes EEG monitoring during surgery.
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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