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See a sample rate comparisonCPT 95938 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.
Test Of Nerve Signaling, The Test Is Called Somatosensory Evoked Potentials (Seps). It Tests The Ability Of Nerves To Conduct Signals Of Sensation To The Brain. Electrical Impulses Are Sent Through Electrodes Placed On The Skin. An Eeg Records Nerve Responses.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $400.14 national non-facility rate (2026) · View Medicare rates for 95938 |
| Medicaid Fee Schedule | $322.405 median of the 8 states in the free preview · View Medicaid rates for 95938 |
National average reimbursement for CPT 95938 by major payers:
$420.07
$436.05
$497.55
$574.53
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CPT 95938
5 of 25 sample ratesHigher to lower in this preview
David Hsu
Aurora Medical Group Inc
$1,277.61Published rateMark Alter
$595.77Published rateAli Anwar
Community Home Physicians LLC D/B/A Community Physicians
$311.07Published rateNathan Ontrop
Advocate Health And Hospitals Corporation
$83.01Published rateChristopher Johnson
Southern Illinois Healthcare Foundation Inc
$45.13Published rate
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See a sample payer proposalCPT 95938 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95938 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 95938 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 |
|---|---|---|
| 95925-CPT | Moderate | Test Of Nerve Signaling, The Test Is Called Somatosensory Evoked Potentials (Seps). It Tests The Ability Of Nerves To Conduct Signals Of Sensation To The Brain. Electrical Impulses Are Sent Through Electrodes Placed On The Skin. An Eeg Records Nerve Responses. |
| 95926-CPT | Low | Test Of Nerve Signaling, The Test Is Called Somatosensory Evoked Potentials (Seps). It Tests The Ability Of Nerves To Conduct Signals Of Sensation To The Brain. Electrical Impulses Are Sent Through Electrodes Placed On The Skin. An Eeg Records Nerve Responses. |
| 95927-CPT | Low | Test Of Nerve Signaling, The Test Is Called Somatosensory Evoked Potentials (Seps). It Tests The Ability Of Nerves To Conduct Signals Of Sensation To The Brain. Electrical Impulses Are Sent Through Electrodes Placed On The Skin. An Eeg Records Nerve Responses. |
| 95938-CPT | Moderate | Test Of Nerve Signaling, The Test Is Called Somatosensory Evoked Potentials (Seps). It Tests The Ability Of Nerves To Conduct Signals Of Sensation To The Brain. Electrical Impulses Are Sent Through Electrodes Placed On The Skin. An Eeg Records Nerve Responses. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95938. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95938 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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Frequently Asked Questions
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are crucial for billing and reimbursement, as they standardize the reporting of procedures and services across the healthcare industry.
To find the cost of a medical procedure, you can use online tools that provide fee schedule lookups. For specific CPT codes and locations, you can check resources like Payerprice, which offers a fee schedule lookup tool. It's also advisable to contact your insurance provider directly for an estimate of your out-of-pocket expenses, as costs can vary based on your plan, deductible, and network status.
Prices for the same medical procedure can vary significantly due to several factors, including the specific healthcare provider or facility, geographic location, negotiated rates with different insurance companies, the patient's insurance plan, and whether the provider is in-network or out-of-network. Hospital systems, independent clinics, and specialty centers often have different pricing structures.
A fee schedule is a comprehensive list of fees used by healthcare providers and insurance companies to define the maximum allowable charges for specific medical services, procedures, and supplies. It dictates how much a provider can bill for a service and how much an insurer will reimburse for it. These schedules are often based on CPT codes.
To determine your specific out-of-pocket costs, you should consult your insurance plan details, including your deductible, co-payment, and co-insurance. You can also contact your insurance provider directly for an estimate based on your specific benefits. For general procedure costs by CPT code and location, tools like Payerprice can provide valuable information, but your individual costs will depend on your insurance coverage.