CPT code 95971: Neurostimulator programming, simple spinal/peripheral nerve2026 Medicare rate & RVUs in Illinois
Report this service when an implanted spinal cord or peripheral nerve neurostimulator is analyzed and its settings receive simple programming adjustments.
Medicare pays $49.83–$53.76 for 95971 in the office in Illinois, from Rest of Illinois to Chicago, IL. 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 95971 covers
Code 95971 describes analysis and simple programming of an implanted neurostimulator used for spinal cord or peripheral nerve stimulation. A clinician managing the device uses a programmer to review its operation and make simple setting adjustments. Common settings include pain-management clinics and follow-up visits for patients with implanted spinal cord stimulators for chronic pain or peripheral nerve stimulators.
Choose this code when the device stimulates the spinal cord or a peripheral nerve and programming is performed. Use 95970 when the device is analyzed without programming, and 95972 when programming is complex. Documentation should identify the device and stimulation site, the findings reviewed, the settings changed, and the patient's response. Do not report a no-change device check as programming. The CMS fee schedule assigns work, practice-expense, and malpractice values, with different practice-expense values for 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 95971 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$49.83 to $53.76
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $53.76 | $37.64 |
| East St. Louis, IL | $51.04 | $36.29 |
| Rest of Illinois | $49.83 | $35.20 |
| Suburban Chicago, IL | $53.02 | $36.55 |
How the 95971 rate is calculated
Each of 95971’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 · 95971
RVUs × geographic indexes × conversion factor
Work0.78
0.78 RVUs× 1.000 GPCI
Practice expense0.66
0.66 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
1.5100
Conversion factor
$33.4009
Medicare rate
$50.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95971
95971 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 · 95971
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$50.44
- Non-facility (office)
- $50.44
- Facility
- $34.40
Higher because the practice carries its own overhead.
95971 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95970Neurostimulator analysisWithout programming
- Use 95970 for analysis of an implanted spinal cord or peripheral nerve neurostimulator without programming. Use 95971 when simple programming adjustments are made.
- 95972Stimulator programmingComplex spinal or peripheral nerve
- This code is for complex programming of a spinal cord or peripheral nerve neurostimulator; 95971 is for simple programming of those devices.
- 95976Stimulator programmingCranial nerve, simple
- 95976 covers simple programming of an implanted cranial nerve neurostimulator. Choose 95971 for a spinal cord or peripheral nerve system.
95971 billing questions
When should 95971 be used instead of 95970?
Use 95971 when simple programming adjustments are made to an implanted spinal cord or peripheral nerve neurostimulator. Use 95970 for device analysis without programming.
How is 95971 distinguished from 95972?
Both apply to spinal cord or peripheral nerve neurostimulators, but 95971 represents simple programming and 95972 represents complex programming. The record should support the level of programming performed.
Can 95970 be reported for the analysis during a 95971 service?
95971 includes analysis with programming. Do not separately report 95970 for the same device analysis performed as part of that programming service.
What documentation supports 95971?
Document the implanted device and stimulation site, the pre-adjustment assessment, the settings changed, and the patient's response. The note should support that programming was performed and was simple.
Does 95971 apply to an implanted vagus nerve stimulator?
No. For cranial nerve neurostimulator programming, the simple-programming code is 95976; 95971 is for spinal cord or peripheral nerve stimulation.
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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