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See a sample rate comparisonCPT 95919 Fee Schedule
Last Verified: October 2026
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.
Quantitative Pupillometry With, Quantitative Pupillometry With Physician Or Other Qualified Health Care Professional Interpretation And Report Unilateral Or Bilateral
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 20 - Urgent Care Facility |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $16.70 national non-facility rate (2026) · View Medicare rates for 95919 |
| Medicaid Fee Schedule | $12.675 median of the 8 states in the free preview · View Medicaid rates for 95919 |
National average reimbursement for CPT 95919 by major payers:
$19.44
$20.02
$19.25
$35.06
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CPT 95919
5 of 25 sample ratesHigher to lower in this preview
John Millichap
Warren Clinic Inc
$40.50Published rateHaidar Kabbani
$28.38Published rateMatthew Niedzwiecki
$19.70Published rateGaurav Yadava
Rita Yadava Mdsc
$11.14Published rateKapil Aedma
Swope Health Services
$5.69Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 95919 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95919 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 95919 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 |
|---|---|---|
| 95919-CPT | Low | Quantitative Pupillometry With, Quantitative Pupillometry With Physician Or Other Qualified Health Care Professional Interpretation And Report Unilateral Or Bilateral |
| 95921-CPT | Low | Autonomic Nrv Parasym Inervj, Testing Of Autonomic Nervous System Function Cardiovagal Innervation Parasympathetic Function Including 2 Or More Of The Following Heart Rate Response To Deep Breathing With Recorded R R Interval Valsalva Ratio And 30 15 Ratio |
| 95922-CPT | Low | Autonomic Nrv Adrenrg Inervj, Testing Of Autonomic Nervous System Function Vasomotor Adrenergic Innervation Sympathetic Adrenergic Function Including Beat To Beat Blood Pressure And R R Interval Changes During Valsalva Maneuver And At Least 5 Minutes Of Passive Tilt |
| 95923-CPT | Low | Autonomic Nrv Syst Funj Test, Testing Of Autonomic Nervous System Function Sudomotor Including 1 Or More Of The Following Quantitative Sudomotor Axon Reflex Test Qsart Silastic Sweat Imprint Thermoregulatory Sweat Test And Changes In Sympathetic Skin Potential |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95919. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95919 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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