CPT code 95822: EEG, sleep or coma only2026 Medicare rate & RVUs in Maryland

Reports an EEG recorded only during sleep or coma, such as when evaluating seizures or abnormal brain function in a patient who is not awake.

CMS RVU26DEffective Oct 1, 20263 payment localities22.1K Medicare services in 2024

Medicare pays $451.88–$521.89 for 95822 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.

$451.88–$521.89Office (non-facility)
—Hospital or facility

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Maryland
  2. What 95822 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 95822 covers

Code 95822 describes an electroencephalogram recorded while the patient is asleep or comatose, rather than an awake-and-asleep routine EEG. Scalp electrodes and EEG equipment capture cerebral electrical activity; an EEG technologist generally performs the recording, and a physician with EEG expertise interprets it. Hospital and outpatient neurodiagnostic services may use this code when the documented recording is limited to sleep or coma, including evaluations of seizures or abnormal brain function.

Choose the code based on the recording state, not just the reason for testing. An EEG that includes awake and asleep phases is reported with 95819; an awake-and-drowsy study is reported with 95816. Documentation should support the patient's state during the recording and the EEG services performed. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the professional component, modifier TC for the technical component, or neither for the global service.

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.

Where 95822 pays more and less in Maryland

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$451.88 to $521.89

$451.88$486.88$521.89
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
95822 office and facility rates by payment locality
Payment localityOfficeFacility
Baltimore area, MD$478.08Unavailable
Rest of Maryland$451.88Unavailable
Washington, DC area$521.89Unavailable

How the 95822 rate is calculated

Each of 95822’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 · 95822

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.05

1.05 RVUs× 1.000 GPCI

Practice expense12.23

12.23 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

13.3800

Conversion factor

$33.4009

Medicare rate

$446.90

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

Payment rules and modifiers for 95822

The CMS indicators that decide how 95822 is paid alongside other services.

CMS payment indicators · 95822

EEG, sleep or coma only

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/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

95822 without 26 · national office

$446.90

EEG, sleep or coma only

95822-26 · Professional component

$56.78

Pays only the interpretation and report.

When to use modifier 26

95822 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 95822

    EEG, sleep or coma only1.05 wRVU

    $446.90

  • 95816

    EEG, awake and drowsy1.05 wRVU

    $413.50−$33.40

  • 95819

    EEG, awake and asleep recording1.05 wRVU

    $482.31+$35.41

  • 95812

    EEG monitoring, 41–60 minutes1.08 wRVU

    $383.11−$63.79

  • 95813

    EEG recording, 61–119 minutes1.63 wRVU

    $479.64+$32.74

How to choose

95816EEGAwake and drowsy
Use 95822 for recording limited to sleep or coma. Use 95816 when the EEG includes awake and drowsy recording.
95819EEGAwake and asleep recording
Use 95822 for sleep-only or coma-only recording; 95819 describes an EEG that captures both awake and asleep phases.
95812EEG monitoring41–60 minutes
95812 identifies an EEG by its 41-to-60-minute duration. 95822 is distinguished by sleep-only or coma-only recording.
95813EEG recording61–119 minutes
95813 identifies an extended EEG lasting 61 to 119 minutes. 95822 is distinguished by the patient's state during recording.

95822 billing questions

How does 95822 differ from 95819?

95822 is for an EEG recorded during sleep or coma only. Use 95819 when the study includes both awake and asleep recording.

How does 95822 differ from 95816?

95822 describes sleep-only or coma-only recording. Code 95816 is for an EEG that includes awake and drowsy recording.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff; billing without either modifier represents the global service.

Is the code selected by recording duration?

The distinguishing feature of 95822 is that recording is limited to sleep or coma. Codes 95812 and 95813 identify EEGs by recording duration.

What should the record support?

Document that the EEG was recorded during sleep or coma, along with the recording performed and the physician's interpretation.

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 95822PPRRVU2026_Oct_nonQPP.csv, line 12,562 (RVU26D)

Open CMS sourceHow we calculate rates

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