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See a sample rate comparisonCPT 95940 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.
Ionm In Operatng Room 15 Min, Continuous Intraoperative Neurophysiology Monitoring In The Operating Room One On One Monitoring Requiring Personal Attendance Each 15 Minutes List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 21 - Inpatient Hospital 15 - Mobile Unit |
| Common Modifiers | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $26.72 national non-facility rate (2026) · View Medicare rates for 95940 |
| Medicaid Fee Schedule | $21.78 median of the 8 states in the free preview · View Medicaid rates for 95940 |
National average reimbursement for CPT 95940 by major payers:
$42.52
$43.06
$51.22
$60.58
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CPT 95940
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$208.41Published rateSuraya Kawadry
Loyola University Medical Center
$64.18Published rateChristopher Raio
Mercy Medical Center
$54.18Published rateAnita Pairitz
Indiana University Health Southern Indiana Physicians
$37.43Published rateRoselin Arunachalam
Carle Health Care Incorporated
$30.40Published rate
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See a sample payer proposalCPT 95940 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95940 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 95940 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 |
|---|---|---|
| 95940-CPT | Low | Ionm In Operatng Room 15 Min, Continuous Intraoperative Neurophysiology Monitoring In The Operating Room One On One Monitoring Requiring Personal Attendance Each 15 Minutes List Separately In Addition To Code For Primary Procedure |
| 95941-CPT | Moderate | Ionm Remote 1 Pt Or Per Hr, Continuous Intraoperative Neurophysiology Monitoring From Outside The Operating Room Remote Or Nearby Or For Monitoring Of More Than One Case While In The Operating Room Per Hour List Separately In Addition To Code For Primary Procedure |
| 95957-CPT | Moderate | Computer Analysis Brain Waves, Eeg Recording That Is Analyzed By Computer To Identify The Specific Spiking Type Occurring During An Epileptic Seizure. |
| 95958-CPT | Moderate | Computer Analysis Brain Waves, Eeg Recording That Is Analyzed By Computer To Identify The Specific Spiking Type Occurring During An Epileptic Seizure. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95940. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95940 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 medical professionals to describe medical, surgical, and diagnostic services and procedures. These codes are essential for accurate billing and processing of insurance claims, providing a standardized language across the healthcare industry.
The cost of a medical procedure can vary significantly based on your location, the specific provider, and your insurance coverage. To get an estimate, you can contact your healthcare provider's billing department or your insurance company. For detailed fee schedule information based on specific CPT codes and locations, you can use tools like Payerprice, which offers a fee schedule lookup service.
An in-network provider has a contract with your insurance company, agreeing to provide services at pre-negotiated rates. This typically results in lower out-of-pocket costs for you. An out-of-network provider does not have such a contract, meaning you may pay a higher percentage of the cost, or even the full cost, depending on your plan's benefits and whether it offers out-of-network coverage.
If your claim is denied, the first step is to review the Explanation of Benefits (EOB) from your insurer to understand the specific reason for the denial. You then typically have the right to file an internal appeal with your insurance company, often requiring additional documentation or a letter explaining why you believe the decision should be overturned. If the internal appeal is denied, you may be able to pursue an external review.
For specific fee schedules for medical services based on CPT codes and your location, you should utilize a dedicated fee schedule lookup tool. Payerprice offers such a tool that allows users to search with CPT codes and specific locations to find relevant fee information, helping you understand potential costs.
No, insurance rarely covers the full cost of a procedure. Most insurance plans involve patient responsibility in the form of deductibles (the amount you pay before your insurance starts to pay), co-payments (a fixed amount you pay for a covered service), and co-insurance (a percentage of the cost of a covered service you pay). The amount covered depends on your specific plan benefits, whether the provider is in-network or out-of-network, and if the service is deemed medically necessary.