CPT 95830 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Neurology and Neuromuscular Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 52 - Reduced Services • SA |
| Complexity Level | Moderate |
National average reimbursement for CPT 95830 by major payers:
$541.39
$469.62
$645.55
$809.35
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 95830 | ||||||
United | 95830 | $292.89 | 1760429831 - BRUCE MADSEN | 260210091 - (OR) BRIDGEPORT EYE PHYSICIANS LLC | OR | Ophthalmology Physician (207W00000X) |
United | 95830 | $263.33 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752796815 - CHRISTUS HEALTH ARK-LA-TEX | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $10702.00 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $8538.00 | 1164668471 - STAMFORD HOSPITAL | 60646917 - (CT) STAMFORD HOSPITAL | CT | General Acute Care Hospital (282N00000X) |
United | 95830 | $7194.00 | 1770536120 - EL PASO HEALTHCARE SYSTEM LTD, LAS PALMAS MEDICAL CENTER, A CAMPUS OF LAS PALMAS DEL SOL HEALTHCARE | 742499952 | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $163.44 | 1578898698 - CT CENTER OF FLINT, PLLC, PREMIER IMAGING CENTERS | 261404129 - (MI) CT CENTER OF FLINT PLLC | MI | Radiology Clinic/Center (261QR0200X) |
United | 95830 | $7739.00 | 1144203662 - TOPS SPECIALTY HOSPITAL, LTD., TOPS SURGICAL SPECIALTY HOSPITAL | 760246499 - (TX) TOPS SPECIALTY HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $4637.00 | 1184948762 - HAYWOOD REGIONAL MEDICAL CENTER | 300830918 | NC | General Acute Care Hospital (282N00000X) |
United | 95830 | $595.00 | 1275581852 - ROLLING PLAINS MEMORIAL HOSPITAL | 756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $6462.00 | 1497871628 - METHODIST HEALTH CENTERS, HOUSTON METHODIST SUGAR LAND HOSPITAL | 760545192 - METHODIST HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $3682.00 | 1497021042 - FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER, CLOVIS COMMUNITY PULMONARY | 941156276 - (CA) FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | 95830 | $2252.00 | 1720152945 - SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC, LAKE CHARLES MEMORIAL HOSPITAL | 720551963 - (LA) SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION INC | LA | General Acute Care Hospital (282N00000X) |
United | 95830 | $4953.00 | 1619747938 - EL PASO COUNTY HOSPITAL DISTRICT | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $10364.00 | 1255384533 - COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP, MEDICAL CITY LEWISVILLE | 621682210 - (TX) DE MARKETING AND SALES | TX | General Acute Care Hospital (282N00000X) |
United | 95830 | $9818.00 | 1841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 95830 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95830 code is part of the Medicine Services and Procedures services used for Neurology and Neuromuscular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 95830 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 95709-CPT | Moderate | Electroencephalogram (Eeg) Without Video Review Of Data Technical Description By Eeg Technologist Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance |
| 95829-CPT | High | Electrocorticogram At Surgery |
| 95830-CPT | Moderate | Insertion By Physician Or Other Qualified Health Care Professional Of Sphenoidal Electrodes For Electroencephalographic (Eeg) Recording (Revised 01/01/13) |
| 95836-CPT | Low | Electrocorticogram From An Implanted Brain Neurostimulator Pulse Generator/Transmitter Including Recording With Interpretation And Written Report Up To 30 Days |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95830 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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