How much does Medicare pay for CPT 95957?

Medicare allowed an average of $269.26 per service and paid $213.82 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $574.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95957?

Measurement of brain wave activity (eeg), digital analysis. It was billed 26,868 times to 22,989 Medicare beneficiaries by 330 providers in 2024.

Does 95957 pay differently in an office than a hospital?

Yes. The allowed amount averaged $291.96 in an office setting and $97.40 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 95957 most?

Neurology, with 14,376 services from 157 clinicians. Next are Internal Medicine, Family Practice, Nurse Practitioner.

CPT 95957

Measurement of brain wave activity (eeg), digital analysis

$269.26Medicare-allowed amount per service, averaged across 26,868 services

Providers submitted

$574.37

Asking price, not received

Medicare allowed

$269.26

The fee schedule figure

Medicare paid

$213.82

Balance is patient coinsurance

Providers submitted an average of $574.37 for this code and Medicare allowed $269.26 — 2.1× 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 $213.82 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $291.96
Hospital / facility: $97.40

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. 23,734 services were billed in an office setting and 3,134 in a facility.

Services: 26,868
Beneficiaries: 22,989
Providers billing it: 330
Total allowed: $7,234,478

What Medicare pays for CPT 95957

Across 26,868 services billed by 330 providers to 22,989 beneficiaries, Medicare allowed an average of $269.26 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. 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 95957

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	14,376	13,532	$269.82	157
Internal Medicine	4,267	3,330	$294.38	65
Family Practice	2,301	1,207	$280.53	35
Nurse Practitioner	1,385	845	$189.55	19
General Practice	1,031	932	$317.80	10
Physical Medicine and Rehabilitation	811	792	$153.42	9
Cardiology	674	653	$299.47	3
Independent Diagnostic Testing Facility (IDTF)	519	495	$292.12	5
Psychiatry	263	153	$174.79	6
Anesthesiology	256	202	$266.29	2
Pain Management	240	224	$276.59	4
Obstetrics & Gynecology	191	190	$266.99	2
Neuropsychiatry	168	50	$280.45	1
Geriatric Medicine	89	88	$289.15	1
Emergency Medicine	73	73	$318.07	1

95957 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
California	7,101	$311.77	$221.80	68
Texas	6,342	$214.03	$179.32	87
Maryland	2,506	$346.02	$229.14	8
New York	1,607	$320.33	$222.55	24
Nevada	1,436	$209.48	$168.36	18
New Jersey	1,217	$275.81	$196.46	21
Arizona	997	$277.43	$228.76	11
Mississippi	857	$254.10	$227.35	1
Georgia	809	$279.77	$227.90	12
Michigan	804	$293.71	$218.74	5
North Carolina	471	$266.91	$228.86	9
Florida	349	$267.68	$206.70	14
Utah	269	$104.39	$77.73	1
Tennessee	268	$249.96	$227.65	6
Idaho	260	$96.14	$77.25	3
Missouri	177	$212.02	$201.06	3
Oklahoma	164	$177.19	$162.27	3
Illinois	153	$192.36	$158.20	2
Hawaii	143	$321.37	$229.98	1
Kentucky	131	$97.52	$78.04	1
Washington	119	$305.96	$227.58	2
Virginia	105	$316.50	$222.44	6
Pennsylvania	97	$158.31	$133.55	5
Puerto Rico	91	$251.03	$205.39	5
Colorado	82	$299.04	$226.51	2
South Carolina	73	$270.97	$228.93	2
Massachusetts	42	$147.17	$101.11	2
West Virginia	42	$94.44	$77.91	2
Oregon	40	$282.73	$228.81	1
Arkansas	39	$92.24	$73.12	1
Indiana	37	$164.67	$139.13	2
Delaware	26	$286.34	$229.22	1
Louisiana	14	$243.26	$229.66	1

Related codes

95911Nerve conduction$197.67
95910Nerve conduction$157.37
95938Placement of skin electrodes and measurement of stimulated sites on ar$55.24
95923Testing of autonomic (sympathetic) nervous system function$121.40
95909Nerve conduction$117.92
95992Repositioning exercises of head for treatment of dizziness$41.72
95913Nerve conduction$267.08
95912Nerve conduction$234.05
95921Testing of autonomic nervous system function and heart rate response t$87.65
95939Placement of skin electrodes and measurement of central motor stimulat$122.96
95984Electronic analysis of implanted brain$41.14
95983Electronic analysis of implanted brain$46.17

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.