CPT code 95970: Neurostimulator analysis, without programming2026 Medicare rate & RVUs in Massachusetts
Reports electronic assessment of an implanted spinal cord or peripheral nerve stimulator when the device is checked without changing its programmed settings.
Medicare pays $20.06–$21.44 for 95970 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 95970 covers
CPT 95970 captures electronic interrogation of an implanted neurostimulator pulse generator for a spinal cord or peripheral nerve system when the visit assesses device operation without changing its programmed settings. The clinician reviews available device information, such as operating status, stored diagnostics, or battery status, and evaluates system function. This service commonly occurs during follow-up for patients with implanted spinal cord stimulation for chronic pain or peripheral nerve stimulation, in pain medicine, neurology, or neurosurgery settings. It concerns the implanted generator system, rather than EEG or intraoperative neurophysiologic monitoring.
Report the code when documentation supports device analysis without programming. Identify the implanted system and its site, describe the analysis performed and findings, and distinguish interrogation from parameter changes. If stimulation parameters are adjusted, choose the applicable with-programming code based on device type and service complexity. CMS valuation includes physician work, practice expense, and malpractice; practice-expense values differ between office and facility settings.
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 95970 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $21.44 | $17.05 |
| Rest of Massachusetts | $20.06 | $16.19 |
How the 95970 rate is calculated
Each of 95970’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 · 95970
RVUs × geographic indexes × conversion factor
Work0.35
0.35 RVUs× 1.000 GPCI
Practice expense0.21
0.21 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
0.5900
Conversion factor
$33.4009
Medicare rate
$19.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95970
95970 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 95970
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$19.71
- Non-facility (office)
- $19.71
- Facility
- $16.03
Higher because the practice carries its own overhead.
95970 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95971Neurostimulator programmingSimple spinal/peripheral nerve
- Use 95970 when the spinal or peripheral nerve stimulator is analyzed without changing settings. Use 95971 when simple programming is performed.
- 95972Stimulator programmingComplex spinal or peripheral nerve
- 95972 represents complex programming of a spinal or peripheral nerve system; 95970 represents analysis without programming.
- 95976Stimulator programmingCranial nerve, simple
- 95976 is for simple programming of a cranial nerve stimulation system. Select by the implanted device system, not just by the act of interrogation.
- 95983Brain stimulator programmingInitial 15 minutes
- 95983 addresses programming of a brain neurostimulator. Code 95970 is for analysis without programming of a spinal cord or peripheral nerve system.
95970 billing questions
How does 95970 differ from 95971 or 95972?
95970 describes analysis without programming. Codes 95971 and 95972 describe programming for spinal cord or peripheral nerve systems, at simple and complex levels, respectively.
Does this code include changing stimulation settings?
No. It represents analysis without changing programmed settings; report the applicable with-programming code when parameters are adjusted.
Is 95970 used for cranial nerve or brain stimulators?
This code is for spinal cord or peripheral nerve systems. Cranial nerve systems have codes 95976 and 95977, while brain neurostimulator programming is represented by 95983 and 95984.
What documentation supports reporting 95970?
Document the implanted system and site, the electronic analysis performed, the findings, and that programmed settings were not changed.
Is 95970 reported in timed increments?
The service is not described in timed increments. Documentation should support the device analysis performed, rather than elapsed minutes.
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
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