How much does Medicare pay for CPT 95819?

Medicare allowed an average of $239.95 per service and paid $187.92 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $593.90, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95819?

Measurement of brain wave activity (eeg), awake and asleep. It was billed 140,912 times to 132,435 Medicare beneficiaries by 2,524 providers in 2024.

Does 95819 pay differently in an office than a hospital?

Yes. The allowed amount averaged $445.41 in an office setting and $55.34 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 95819 most?

Neurology, with 130,664 services from 2,419 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Internal Medicine, Neuropsychiatry.

CPT 95819

Measurement of brain wave activity (eeg), awake and asleep

$239.95Medicare-allowed amount per service, averaged across 140,912 services

Providers submitted

$593.90

Asking price, not received

Medicare allowed

$239.95

The fee schedule figure

Medicare paid

$187.92

Balance is patient coinsurance

Providers submitted an average of $593.90 for this code and Medicare allowed $239.95 — 2.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $187.92 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $445.41
Hospital / facility: $55.34

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 66,689 services were billed in an office setting and 74,223 in a facility.

Services: 140,912
Beneficiaries: 132,435
Providers billing it: 2,524
Total allowed: $33,811,834

What Medicare pays for CPT 95819

Across 140,912 services billed by 2,524 providers to 132,435 beneficiaries, Medicare allowed an average of $239.95 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95819

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	130,664	124,691	$230.57	2,419
Independent Diagnostic Testing Facility (IDTF)	5,022	3,461	$465.19	13
Internal Medicine	1,177	817	$343.92	11
Neuropsychiatry	828	817	$97.98	14
Pulmonary Disease	570	281	$497.65	5
Epileptologists	427	408	$208.66	6
Psychiatry	359	340	$288.47	6
Sleep Medicine	317	290	$190.03	10
Pediatric Medicine	239	232	$128.93	7
Hospitalist	226	206	$54.26	4
Critical Care (Intensivists)	223	170	$445.58	4
Neurosurgery	165	164	$53.38	6
Nephrology	162	155	$199.29	3
Cardiology	144	96	$261.81	4
Pain Management	135	127	$174.44	2

95819 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	18,914	$280.02	$215.86	278
California	17,257	$289.41	$197.87	251
Texas	12,942	$276.28	$226.10	203
New York	9,812	$334.93	$231.86	154
Maryland	7,947	$351.55	$235.09	74
Michigan	6,757	$213.71	$170.62	112
Illinois	6,127	$124.58	$96.76	131
New Jersey	5,668	$252.64	$177.61	78
Alabama	4,883	$211.70	$186.10	58
Pennsylvania	4,741	$112.99	$92.14	117
Virginia	3,982	$269.70	$198.33	68
Arizona	3,441	$355.91	$290.61	65
Massachusetts	3,013	$119.93	$88.74	63
Georgia	2,965	$242.40	$201.26	76
Ohio	2,930	$125.13	$103.10	85
Nevada	2,799	$228.78	$182.75	33
Indiana	2,448	$116.83	$98.90	62
Louisiana	1,870	$251.39	$220.96	37
Oklahoma	1,863	$176.01	$153.88	28
North Carolina	1,833	$148.58	$124.21	58
Missouri	1,648	$53.11	$41.59	43
Washington	1,437	$234.28	$167.52	39
Kentucky	1,429	$63.38	$52.77	26
Tennessee	1,420	$118.92	$102.62	32
Colorado	1,260	$179.00	$136.18	29
South Carolina	935	$195.72	$164.47	29
Wisconsin	872	$80.69	$68.55	35
District of Columbia	849	$286.07	$188.53	11
Kansas	813	$121.82	$102.61	18
Iowa	771	$72.93	$59.23	21
Arkansas	698	$217.70	$193.20	19
Connecticut	644	$58.51	$41.91	16
Hawaii	589	$388.13	$273.35	8
Mississippi	587	$86.94	$74.73	15
West Virginia	558	$289.46	$274.38	8
Oregon	544	$151.17	$117.43	19
Puerto Rico	435	$331.29	$258.04	19
Delaware	355	$385.70	$303.31	3
Minnesota	340	$94.84	$71.58	16
Utah	334	$240.44	$202.50	10
South Dakota	312	$53.01	$42.13	13
Nebraska	307	$53.16	$40.51	9
Rhode Island	296	$131.62	$99.24	11
New Mexico	295	$148.07	$127.75	6
Idaho	250	$52.77	$43.29	8
New Hampshire	195	$55.16	$42.09	7
Montana	129	$179.19	$141.93	5
North Dakota	125	$53.52	$42.08	7
U.S. Virgin Islands	98	$422.00	$349.97	1
Maine	87	$53.49	$40.58	6
Guam	55	$524.78	$349.60	1
Vermont	35	$52.15	$42.59	2
Alaska	18	$72.05	$40.88	1

Related codes

95886Needle measurement of electrical activity in arm or leg muscles$86.76
95816Measurement of brain wave activity (eeg)$227.96
95811Sleep study in sleep lab$314.61
95810Sleep study in sleep lab (6 years or older)$309.74
95800Sleep study including heart rate$117.17
95885Needle measurement of electrical activity in arm or leg muscles$46.74
95806Sleep study including heart rate$54.06
95874Needle measurement of electrical activity in muscle$53.46
95861Needle measurement of electrical activity in arm or leg muscles$80.08
95870Needle measurement of electrical activity in arm$19.70
95813Measurement of brain wave activity (eeg)$202.49
95812Measurement of brain wave activity (eeg)$191.83

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.