How much does Medicare pay for CPT 95971?

Medicare allowed an average of $43.47 per service and paid $32.72 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $164.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 95971 pay differently in an office than a hospital?

Yes. The allowed amount averaged $44.24 in an office setting and $36.18 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 95971 most?

Urology, with 3,961 services from 73 clinicians. Next are Nurse Practitioner, Physician Assistant, Obstetrics & Gynecology.

CPT 95971

Electronic analysis of implanted neurostimulator generator with simple spinal cord or peripheral nerve stimulator programming

$43.47Medicare-allowed amount per service, averaged across 10,419 services

Providers submitted

$164.13

Asking price, not received

Medicare allowed

$43.47

The fee schedule figure

Medicare paid

$32.72

Balance is patient coinsurance

Providers submitted an average of $164.13 for this code and Medicare allowed $43.47 — 3.8× 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 $32.72 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $44.24
Hospital / facility: $36.18

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. 9,419 services were billed in an office setting and 1,000 in a facility.

Services: 10,419
Beneficiaries: 6,169
Providers billing it: 259
Total allowed: $452,914

What Medicare pays for CPT 95971

Across 10,419 services billed by 259 providers to 6,169 beneficiaries, Medicare allowed an average of $43.47 per service. That is 1.7 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 95971

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	3,961	1,821	$46.57	73
Nurse Practitioner	1,893	1,295	$37.40	52
Physician Assistant	1,165	829	$37.82	39
Obstetrics & Gynecology	1,035	683	$46.13	30
Pain Management	643	384	$45.45	9
Anesthesiology	473	322	$43.29	19
Neurosurgery	365	267	$42.17	9
Sleep Medicine	203	81	$45.94	2
Interventional Pain Management	202	138	$46.68	9
Physical Medicine and Rehabilitation	194	145	$47.96	7
Otolaryngology	96	68	$45.30	3
Neurology	87	61	$41.81	3
Colorectal Surgery (Proctology)	50	29	$53.38	1
Epileptologists	23	19	$35.74	1
Certified Nurse Midwife	16	15	$43.87	1

95971 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	1,367	$47.44	$35.76	17
Florida	1,099	$46.46	$34.41	25
Arizona	721	$46.33	$35.32	8
Kentucky	536	$37.56	$29.94	6
Tennessee	464	$38.95	$30.32	17
Ohio	458	$42.10	$33.05	16
Texas	456	$42.72	$34.09	18
Indiana	451	$43.13	$33.83	6
Georgia	401	$41.04	$29.98	11
Missouri	387	$37.70	$29.91	12
New York	384	$51.12	$35.79	12
Oklahoma	367	$42.11	$33.20	9
Mississippi	348	$39.99	$32.67	5
Pennsylvania	330	$42.92	$33.13	8
South Carolina	297	$43.95	$35.27	10
Minnesota	230	$42.86	$31.96	6
Alabama	222	$40.57	$33.94	5
North Carolina	219	$44.33	$35.46	6
Arkansas	196	$34.58	$27.64	3
Virginia	165	$44.02	$33.77	5
Massachusetts	161	$48.66	$34.34	3
Michigan	154	$40.43	$30.01	7
Illinois	154	$43.50	$32.10	7
New Jersey	144	$46.78	$33.45	5
Kansas	107	$39.65	$31.98	4
Washington	105	$47.19	$36.43	4
Louisiana	76	$36.28	$26.80	3
Maryland	68	$49.55	$36.45	3
Iowa	55	$37.03	$31.12	3
Nevada	53	$39.99	$30.22	2
Oregon	50	$46.44	$36.76	2
Nebraska	31	$40.46	$33.88	2
Maine	27	$32.05	$23.63	1
Delaware	25	$39.98	$30.60	1
Wisconsin	23	$35.74	$28.79	1
District of Columbia	18	$52.48	$33.23	1
Connecticut	16	$49.86	$37.51	1
New Hampshire	15	$40.89	$31.73	1
South Dakota	15	$45.70	$35.13	1
Colorado	13	$48.24	$34.64	1
Montana	11	$32.16	$25.51	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.