CPT code 95251: CGM interpretation, analysis, interpretation, and report2026 Medicare rate & RVUs in Brazoria, TX

Physician or qualified practitioner review, interpretation, and written report of at least 72 hours of continuous glucose monitoring data from patient-owned or practice-provided equipment.

CMS RVU26DEffective Oct 1, 2026One payment locality841.7K Medicare services in 2024

In Brazoria, TX, Medicare pays $34.79 for 95251 in the office and $34.79 when it’s performed in a hospital or facility.

$34.79Office (non-facility)
$34.79Hospital or facility
−0.8%vs the national office rate ($35.07)

Check a contract rate as a % of Medicare · 95251 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 95251 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Brazoria, TX
  2. What 95251 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 95251 covers

This service is the clinician's evaluation of at least 72 hours of interstitial glucose readings recorded by a subcutaneous sensor. A physician, nurse practitioner, or physician assistant reviews a downloaded or remotely uploaded ambulatory glucose profile from a Dexcom, FreeStyle Libre, or similar system. The practitioner assesses time in range, low and high glucose excursions, overnight and postprandial patterns, and variability, then writes patient-specific findings and recommendations such as insulin dose or timing changes. Endocrinology and primary care practices perform these reviews for patients with type 1 or insulin-treated type 2 diabetes.

Report 95251 no more than once per month for a monitoring period of at least 72 hours, even if data are reviewed multiple times. Document the monitoring dates and a signed interpretation; a device printout without clinical analysis is insufficient. CMS classifies 95251 as professional-component-only, covering analysis, interpretation, and report; do not append modifier 26. When performed, patient-owned CGM startup and training are described by 95249, while 95250 describes setup and recording using practice-provided equipment. Neither technical service is required for 95251 when a patient's existing device provides the data.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Brazoria, TX compares for 95251

Across 109 of 109 payment localities, the office rate for 95251 runs from $32.75 in Arkansas to $46.37 in Alaska. Brazoria, TX pays $34.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

95251 in Brazoria, TX vs other payment areas
  1. Brazoria, TX · this page$34.79
  2. Austin, TX · Texas$35.55+$0.76
  3. Beaumont, TX · Texas$33.99−$0.80
  4. Dallas, TX · Texas$35.00+$0.21
  5. Fort Worth, TX · Texas$34.91+$0.12
  6. Galveston, TX · Texas$34.89+$0.10
  7. Houston, TX · Texas$35.81+$1.02

Other areas in Texas first, then benchmark localities. Bars start at $0.

Every other payment area

95251 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$34.36$34.36
Los Angeles, CACalifornia$37.40$37.40
Washington, DC areaDistrict of Columbia$38.39$38.39
Miami, FLFlorida$38.06$38.06
Chicago, ILIllinois$37.45$37.45
Manhattan, NYNew York$39.23$39.23
AlaskaAlaska$46.37$46.37
AlabamaAlabama$33.01$33.01

95251 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$32.75

$46.37

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95251 office rate range by state
State / territoryOffice rate rangeLocalities
AK$46.371
AL$33.011
AR$32.751
AZ$34.501
CA$35.71–$41.5229
CO$35.661
CT$36.701
DC$38.391
DE$34.891
FL$35.44–$38.063
GA$34.24–$35.652
GU$35.831
HI$35.831
IA$33.161
ID$33.341
IL$35.08–$37.454
IN$33.431
KS$33.221
KY$33.741
LA$33.77–$34.672
MA$35.66–$37.892
MD$35.29–$38.393
ME$33.58–$34.362
MI$34.36–$35.842
MN$34.211
MO$33.55–$34.563
MS$33.151
MT$35.071
NC$33.751
ND$34.081
NE$33.211
NH$35.301
NJ$37.12–$38.332
NM$34.521
NV$34.801
NY$34.04–$39.985
OH$34.151
OK$33.551
OR$34.53–$36.192
PA$34.10–$36.242
PR$35.161
RI$35.671
SC$34.011
SD$33.961
TN$33.331
TX$33.99–$35.818
UT$34.261
VA$34.40–$38.392
VI$35.161
VT$34.141
WA$35.53–$38.332
WI$33.471
WV$34.391
WY$34.641

See 95251 in every payment locality

How the 95251 rate is calculated

Each of 95251’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 95251

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.68

0.68 RVUs× 1.000 GPCI

Practice expense0.32

0.32 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.0500

Conversion factor

$33.4009

Medicare rate

$35.07

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Brazoria, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,493

Code
95251
Physician work
0.68
Practice expense
0.32
Malpractice
0.05

GPCI2026.csv

98

Locality
Brazoria, TX
Physician work
1.008
Practice expense
0.991
Malpractice
0.780
Office calculation for 95251 in Brazoria, TX
ComponentRVULocality factorAdjusted
Physician work0.68× 1.0080.6854
Practice expense0.32× 0.9910.3171
Malpractice0.05× 0.7800.0390
Total RVUs1.0416
Conversion factor× 33.4009

Office rate, Brazoria, TX$34.79

Office: (0.68 × 1.008 + 0.32 × 0.991 + 0.05 × 0.78) × $33.4009 = $34.79

Facility: (0.68 × 1.008 + 0.32 × 0.991 + 0.05 × 0.78) × $33.4009 = $34.79

Open 95251 in the RVU calculator

Payment rules and modifiers for 95251

The CMS indicators that decide how 95251 is paid alongside other services.

CMS payment indicators · 95251

CGM interpretation, analysis, interpretation, and report

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical2Professional component only.

How 95251 has changed in Brazoria, TX

95251 · Office / nonfacility

$34.79

Effective 2026-10-01

The base rate is $1.37 higher than on 2025-10-01, moving from $33.42 to $34.79 (4.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $33.42changed to$34.79

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.70 changed to 0.68
    • Practice expense RVU 0.29 changed to 0.32
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.006 changed to 0.991
    • Malpractice GPCI 0.795 changed to 0.780

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $34.40changed to$33.42

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $33.84changed to$34.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $34.80changed to$33.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.28 changed to 0.29
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.014 changed to 1.006
    • Malpractice GPCI 0.673 changed to 0.795
  5. January 1, 2023

    RVU23A

    $35.67changed to$34.80

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.023 changed to 1.014
    • Malpractice GPCI 0.550 changed to 0.673

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $35.97changed to$35.67

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $37.02changed to$35.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.27 changed to 0.28
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.010 changed to 1.023
    • Malpractice GPCI 0.695 changed to 0.550

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $36.64changed to$37.02

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.04 changed to 0.05
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 0.997 changed to 1.010
    • Malpractice GPCI 0.839 changed to 0.695

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $36.96changed to$36.64

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.28 changed to 0.27

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $44.85changed to$36.96

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 0.85 changed to 0.70
    • Practice expense RVU 0.34 changed to 0.28
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.994 changed to 0.997
    • Malpractice GPCI 0.897 changed to 0.839

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $44.42changed to$44.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.33 changed to 0.34
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 0.990 changed to 0.994
    • Malpractice GPCI 0.955 changed to 0.897

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $44.24changed to$44.42

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.04 changed to 0.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $44.02changed to$44.24

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $44.27changed to$44.02

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.34 changed to 0.33
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 0.989 changed to 0.990
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $42.53changed to$44.27

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.36 changed to 0.34
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 0.987 changed to 0.989
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $42.53

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$34.79$34.79RVU26D
2026-07-01$34.79$34.79RVU26C
2026-04-01$34.79$34.79RVU26B
2026-01-01$34.79$34.79RVU26A
2025-10-01$33.42$33.42RVU25D
2025-07-01$33.42$33.42RVU25C
2025-04-01$33.42$33.42RVU25B
2025-01-01$33.42$33.42RVU25A
2024-10-01$34.40$34.40RVU24D
2024-07-01$34.40$34.40RVU24C
2024-04-01$34.40$34.40RVU24B
2024-03-09$34.40$34.40RVU24AR
2024-01-01$33.84$33.84RVU24A
2023-10-01$34.80$34.80RVU23D
2023-07-01$34.80$34.80RVU23C
2023-04-01$34.80$34.80RVU23B
2023-01-01$34.80$34.80RVU23A
2022-10-01$35.67$35.67RVU22D
2022-07-01$35.67$35.67RVU22C
2022-04-01$35.67$35.67RVU22B
2022-01-01$35.67$35.67RVU22A
2021-10-01$35.97$35.97RVU21D
2021-07-01$35.97$35.97RVU21C
2021-04-01$35.97$35.97RVU21B
2021-01-01$35.97$35.97RVU21A
2020-10-01$37.02$37.02RVU20D
2020-07-01$37.02$37.02RVU20C
2020-04-01$37.02$37.02RVU20B
2020-01-01$37.02$37.02RVU20A
2019-10-01$36.64$36.64RVU19D
2019-07-01$36.64$36.64RVU19C
2019-04-01$36.64$36.64RVU19B
2019-01-01$36.64$36.64RVU19A
2018-10-01$36.96$36.96RVU18D
2018-07-01$36.96$36.96RVU18C
2018-04-01$36.96$36.96RVU18B
2018-01-01$36.96$36.96RVU18AR1
2017-10-01$44.85$44.85RVU17D
2017-07-01$44.85$44.85RVU17C
2017-04-01$44.85$44.85RVU17B
2017-01-01$44.85$44.85RVU17A
2016-10-01$44.42$44.42RVU16D
2016-07-01$44.42$44.42RVU16C
2016-04-01$44.42$44.42RVU16B
2016-01-01$44.42$44.42RVU16A
2015-10-01$44.24$44.24RVU15D
2015-07-01$44.24$44.24RVU15C
2015-04-01$44.02$44.02RVU15B
2015-01-01$44.02$44.02RVU15A
2014-10-01$44.27$44.27RVU14D
2014-07-01$44.27$44.27RVU14C
2014-04-01$44.27$44.27RVU14B
2014-01-01$44.27$44.27RVU14A
2013-10-01$42.53$42.53RVU13D
2013-07-01$42.53$42.53RVU13C
2013-04-01$42.53$42.53RVU13B
2013-01-01$42.53$42.53RVU13AR

Price 95251 for an earlier date of service

Where the Brazoria, TX rate applies

Brazoria, TX is a Medicare payment area, not a city. Our Census mapping connects it to 28 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

  • Brazoria
  • Alvin
  • Angleton
  • Bailey's Prairie
  • Bonney
  • Brookside Village
  • Clute
  • Damon

Browse all communities in Texas

95251 billing questions

Can 95251 be billed on the same day as an office visit?

Yes. The CGM interpretation can be reported with a separately documented E/M service on the same date. The time and work spent interpreting the CGM data should not also be counted toward the E/M level.

Does 95251 require a face-to-face encounter?

No. The interpretation can be performed from data the patient uploads to a cloud platform or brings to the office. The billable work is the analysis and written report, not a visit.

How often can 95251 be reported?

Report it no more than once per month, regardless of how many times the data are reviewed during that month. The interpretation requires at least 72 hours of monitoring.

Should modifier 26 be appended to 95251?

No. The code already represents the professional interpretation and report. When performed, patient-owned CGM startup and training are described by 95249; setup and recording with practice-provided equipment are described by 95250.

Is 95251 billable when the patient uses their own personal CGM?

Yes. Interpretation of data from a patient-owned device is reported with 95251. Report 95249 only if the practice also performed the startup, hookup, and training for that device.

What documentation supports 95251?

The record should show monitoring dates covering at least 72 hours and a patient-specific interpretation of glucose patterns. It should also document the clinician's recommendations or management changes and the interpreting practitioner's signature.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 95251PPRRVU2026_Oct_nonQPP.csv, line 12,493 (RVU26D)
Geographic factors for Brazoria, TXGPCI2026.csv, line 98 (RVU26D)

Open CMS sourceHow we calculate rates

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