Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 95991 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.
Spin Brain Pump Refil Main, Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery Spinal Intrathecal Epidural Or Brain Intraventricular Includes Electronic Analysis Of Pump When Performed Requiring Skill Of A Physician Or Other Qualified Health Care Professional
| 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 | 59 - Distinct Procedural Service PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $115.90 national non-facility rate (2026) · View Medicare rates for 95991 |
| Medicaid Fee Schedule | $91.375 median of the 8 states in the free preview · View Medicaid rates for 95991 |
National average reimbursement for CPT 95991 by major payers:
$136.46
$138.55
$141.26
$76.02
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 95991.
CPT 95991
5 of 25 sample ratesHigher to lower in this preview
Indiana University Health Inc
$7,480.00Published rateSeventh-Day Adventists Loma Linda University Medical Center, Loma Linda Univeristy Medical Center
Seventh-Day Adventists Loma Linda University Medical Center Inc
$1,932.00Published rateChildren'S Hospital
Childrens Hospital Inc
$1,191.00Published rateIntegris South Oklahoma City Hospital Corporation
$465.00Published rateFrederick'S Radiology & Diagnostic Center, LLC
Fredericks Radiology Diagnostic Center LLC
$59.06Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 95991 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95991 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 95991 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 |
|---|---|---|
| 95983-CPT | Low | Alys Brn Npgt Prgrmg 15 Min, 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 Brain Neurostimulator Pulse Generator Transmitter Programming First 15 Minutes Face To Face Time With Physician Or Other Qualified Health Care Professional |
| 95984-CPT | Low | Alys Brn Npgt Prgrmg Addl 15, 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 Brain Neurostimulator Pulse Generator Transmitter Programming Each Additional 15 Minutes Face To Face Time With Physician Or Other Qualified Health Care Professional List Separately In Addition To Code For Primary Procedure |
| 95990-CPT | Low | Spin Brain Pump Refil Main, Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery Spinal Intrathecal Epidural Or Brain Intraventricular Includes Electronic Analysis Of Pump When Performed |
| 95991-CPT | Low | Spin Brain Pump Refil Main, Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery Spinal Intrathecal Epidural Or Brain Intraventricular Includes Electronic Analysis Of Pump When Performed Requiring Skill Of A Physician Or Other Qualified Health Care Professional |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95991. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95991 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 95991) and we'll show you how you compare in 15 minutes or less.