CPT 95976 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 |
| Common Modifiers | • None • 59 - Distinct Procedural Service • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
National average reimbursement for CPT 95976 by major payers:
$52.84
$53.62
$54.73
$72.63
| 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 95976 | ||||||
United | 95976 | $31.86 | 1154327518 - MARK DEBRUIN | 680377991 - (CA) DEBRUIN MEDICAL CENTER, A PROFESSIONAL CORPORATION | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $35.40 | 1588197826 - MIGUEL ALVAREZ-ESTRADA | 952801772 - (CA) CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $40.68 | 1427618685 - MADELINE UNDERWOOD | 271346767 | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $59.34 | 1073539136 - MICHELLE GONZALES | 262364868 - (CA) MICHELLE GONZALES MD PC | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $54.29 | 1366683732 - FIROOZEH DASTMALCHI | 261956700 - (CA) OFFICE MD INC. DBA DOWNTOWN MEDICAL GROUP | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $42.50 | 1306425046 - KAYLIN DILBECK | 941732538 - UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $47.25 | 1174506372 - BARBARA WALKER | 271107960 - (VA) FORT NORFOLK PLAZA MEDICAL ASSOCIATES, LLC | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $40.68 | 1366412165 - SAIRA DAR | 471583916 - (CA) ALL INCLUSIVE MEDICAL SERVICES I | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $190.00 | 1326483603 - MEGAN ASH | 680273974 - SUTTER VALLEY MEDICAL FOUNDATION | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $233.80 | 1598727216 - AARON BOOR | 271346767 | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $31.86 | 1326368572 - NOAMAN HANIF | 862258430 - (CA) CURE MEDICALCARE PC | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $58.95 | 1457550956 - IAN HOFFMAN | 920922704 | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $77.88 | 1427162569 - ANDRZEJ KROLIKIEWICZ | 912170164 | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $76.41 | 1790914919 - ALAA ABOULHOSN | 954322584 - (CA) PROVIDENCE FACEY MEDICAL FOUNDATION | CA | Family Medicine Physician (207Q00000X) |
United | 95976 | $34.22 | 1538584263 - SIMICARE MEDICAL GROUP INC | 464958374 - (CA) SIMICARE MEDICAL GROUP INC | CA | Family Medicine Physician (207Q00000X) |
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 95976 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95976 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 95976 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 |
|---|---|---|
| 95965-CPT | High | Magnetoencephalography (Meg), Recording And Analysis; For Spontaneous Brain Magnetic Activity (Eg, Epileptic Cerebral Cortex Localization) |
| 95970-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg Contact Group[S] Interleaving Amplitude Pulse Width Frequency [Hz] On/Off Cycling Burst Magnet Mode Dose Lockout Patient Selectable Parameters Responsiveneurostimulation Detection Algorithms Closed Loop Parameters And Passive Parameters) By Physician Or Other Qualified Health Care Profes- Sional; With Brain Cranial Nerve Spinal Cord Peripheral Nerve Or Sacral Nerve Neurostimulator |
| 95971-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg Contact Group[S] Interleaving Amplitude Pulse Width Frequency [Hz] On/Off Cycling Burst Magnet Mode Dose Lockout Patient Selectable Parameters Responsiveneurostimulation Detection Algorithms Closed Loop Parameters And Passive Parameters) By Physician Or Other Qualified Health Care Profes- Sional With Simple Spinal Cord Or Peripheral Nerve(Eg Sacral Nerve) Neurostimulator Pulse |
| 95976-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg, Contact Group[S], Interleaving, Amplitude, Pulse Width, Frequency [Hz], On/Off Cycling, Burst, Magnet Mode, Dose Lockout, Patient Selectable Parameters, Responsive Neurostimulation, Detection Algorithms, Closed Loop Parameters, And Passive Parameters) By Physician Or Other Qualified Health Care Professional; With Simple Cranial Nerve Neurostimulator Pulse Generator/Transmitter Programming By Physician Or Other Qual |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95976. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95976 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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