How much does Medicare pay for CPT 95970?

Medicare allowed an average of $17.20 per service and paid $12.47 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $155.29, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95970?

Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator. It was billed 16,346 times to 11,673 Medicare beneficiaries by 549 providers in 2024.

Does 95970 pay differently in an office than a hospital?

Yes. The allowed amount averaged $17.35 in an office setting and $16.68 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 95970 most?

Neurology, with 7,194 services from 236 clinicians. Next are Nurse Practitioner, Physician Assistant, Urology.

CPT 95970

Electronic analysis of implanted brain, spinal cord, or peripheral neurostimulator generator

$17.20Medicare-allowed amount per service, averaged across 16,346 services

Providers submitted

$155.29

Asking price, not received

Medicare allowed

$17.20

The fee schedule figure

Medicare paid

$12.47

Balance is patient coinsurance

Providers submitted an average of $155.29 for this code and Medicare allowed $17.20 — 9.0× 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 $12.47 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $17.35
Hospital / facility: $16.68

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. 12,683 services were billed in an office setting and 3,663 in a facility.

Services: 16,346
Beneficiaries: 11,673
Providers billing it: 549
Total allowed: $281,151

What Medicare pays for CPT 95970

Across 16,346 services billed by 549 providers to 11,673 beneficiaries, Medicare allowed an average of $17.20 per service. That is 1.4 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 95970

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	7,194	4,811	$18.25	236
Nurse Practitioner	3,952	2,972	$15.20	133
Physician Assistant	1,635	1,235	$15.20	59
Urology	600	515	$18.44	24
Sleep Medicine	591	417	$17.78	18
Obstetrics & Gynecology	463	326	$17.96	13
Neurosurgery	462	399	$18.42	17
Pulmonary Disease	442	323	$18.50	18
Otolaryngology	426	337	$17.98	11
Internal Medicine	82	39	$18.35	2
Interventional Pain Management	82	40	$18.63	3
Anesthesiology	75	39	$18.85	3
Family Practice	73	62	$17.17	3
Physical Medicine and Rehabilitation	62	27	$17.63	1
Emergency Medicine	46	17	$17.70	1

95970 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	1,565	$18.15	$13.05	47
California	1,552	$18.46	$12.59	55
Texas	1,095	$17.77	$12.88	34
New York	806	$18.89	$12.86	25
Ohio	780	$16.07	$11.72	24
Arizona	769	$17.20	$13.32	20
Pennsylvania	607	$17.09	$12.22	22
Virginia	557	$17.33	$13.07	18
Missouri	553	$15.82	$11.48	16
Illinois	552	$17.48	$12.44	20
Washington	469	$17.79	$12.66	17
Kentucky	432	$16.12	$11.71	14
Kansas	407	$16.04	$11.79	11
Colorado	403	$16.74	$12.42	16
Michigan	363	$16.59	$12.09	15
Indiana	357	$16.63	$12.09	13
Tennessee	345	$15.69	$12.40	15
Iowa	343	$15.99	$12.10	9
Oklahoma	333	$16.74	$12.34	7
New Jersey	320	$19.97	$13.67	10
Mississippi	318	$15.23	$12.27	6
Minnesota	285	$16.72	$12.55	13
Maryland	281	$18.36	$13.44	12
North Carolina	277	$16.55	$12.15	8
Alabama	253	$15.64	$12.16	8
South Dakota	240	$15.16	$12.32	9
Massachusetts	227	$17.90	$12.83	8
Oregon	196	$16.55	$11.87	8
Nebraska	185	$15.99	$12.44	7
Arkansas	161	$15.12	$11.76	7
Idaho	140	$16.72	$12.15	6
Wisconsin	138	$16.13	$11.87	6
South Carolina	129	$16.36	$12.33	5
Georgia	120	$17.49	$12.61	4
West Virginia	117	$17.16	$12.61	5
Louisiana	110	$16.81	$12.30	4
Utah	84	$15.02	$9.71	2
Delaware	70	$17.58	$11.71	3
Maine	63	$15.55	$9.65	4
Vermont	49	$17.16	$12.42	1
Nevada	45	$17.59	$12.46	2
Connecticut	40	$19.72	$13.86	2
New Hampshire	38	$16.98	$11.06	2
Montana	38	$17.10	$11.32	2
New Mexico	33	$18.71	$13.46	2
District of Columbia	31	$19.69	$13.55	2
Rhode Island	30	$15.30	$10.15	1
North Dakota	23	$17.27	$12.31	1
Wyoming	17	$14.90	$11.27	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.