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CPT code 95972: Stimulator programming, complex spinal or peripheral nerve2026 Medicare rate & RVUs in Kentucky

Reports complex programming of an implanted spinal cord or peripheral nerve stimulator when a clinician adjusts multiple device settings to manage stimulation.

CMS RVU26DEffective Oct 1, 2026One payment locality35.4K Medicare services in 2024

In Kentucky, Medicare pays $56.18 for 95972 in the office and $34.20 when it’s performed in a hospital or facility.

$56.18Office (non-facility)
$34.20Hospital or facility
−6.0%vs the national office rate ($59.79)

Check a contract rate as a % of Medicare · 95972 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 95972 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 95972 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 95972 covers

A clinician analyzes and reprograms an implanted spinal cord or peripheral nerve stimulator, often during follow-up for chronic pain when stimulation coverage, symptom control, or treatment tolerance needs adjustment. Programming may involve changing settings such as electrode selection, amplitude, pulse width, frequency, or cycling. Pain specialists, neurologists, neurosurgeons, and other qualified clinicians may perform the service in an office or facility setting.

Choose 95972 for complex programming of a spinal cord or peripheral nerve system, generally when more than three parameters are changed; use the simpler level when fewer parameters are adjusted. Document the device and anatomic system, the clinical reason for programming, settings assessed and changed, and the patient’s response. CMS values the reported service under the physician fee schedule.

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 Kentucky compares for 95972

Across 109 of 109 payment localities, the office rate for 95972 runs from $54.32 in Arkansas to $75.22 in San Benito County, CA. Kentucky pays $56.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

95972 in Kentucky vs other payment areas
  1. Kentucky · this page$56.18
  2. Los Angeles, CA · California$65.72+$9.54
  3. Washington, DC area · District of Columbia$66.96+$10.78
  4. Miami, FL · Florida$64.62+$8.44
  5. Chicago, IL · Illinois$63.16+$6.98
  6. Manhattan, NY · New York$67.85+$11.67
  7. Alaska · Alaska$74.10+$17.92

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

Every other payment area

95972 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$54.93$33.30
ArkansasArkansas$54.32$33.09
ArizonaArizona$58.50$34.55
Bakersfield, CACalifornia$62.33$35.24
Chico, CACalifornia$62.11$35.02
El Centro, CACalifornia$62.12$35.03
Fresno, CACalifornia$62.11$35.02
Hanford, CACalifornia$62.11$35.02

95972 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

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

$54.32

$74.10

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

View every state and territory as a table
95972 office rate range by state
State / territoryOffice rate rangeLocalities
AK$74.101
AL$54.931
AR$54.321
AZ$58.501
CA$62.11–$75.2229
CO$61.561
CT$63.181
DC$66.961
DE$59.321
FL$59.61–$64.623
GA$56.92–$60.832
GU$63.011
HI$63.011
IA$55.771
ID$56.101
IL$58.43–$63.164
IN$56.341
KS$55.681
KY$56.181
LA$56.16–$58.292
MA$61.37–$66.592
MD$60.23–$66.963
ME$56.45–$58.652
MI$57.42–$60.322
MN$59.031
MO$55.49–$58.323
MS$54.911
MT$59.781
NC$56.881
ND$58.401
NE$55.971
NH$60.761
NJ$63.91–$66.552
NM$57.711
NV$59.431
NY$57.56–$69.315
OH$57.131
OK$55.981
OR$58.97–$63.032
PA$57.14–$61.982
PR$60.091
RI$61.061
SC$57.101
SD$58.241
TN$55.911
TX$56.86–$61.368
UT$57.711
VA$58.58–$66.962
VI$60.091
VT$58.331
WA$61.20–$67.672
WI$56.881
WV$56.771
WY$59.181

See 95972 in every payment locality

How the 95972 rate is calculated

Each of 95972’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 · 95972

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.80

0.80 RVUs× 1.000 GPCI

Practice expense0.92

0.92 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

1.7900

Conversion factor

$33.4009

Medicare rate

$59.79

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

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,727

Code
95972
Physician work
0.80
Practice expense
0.92
Malpractice
0.07

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Office calculation for 95972 in Kentucky
ComponentRVULocality factorAdjusted
Physician work0.80× 1.0000.8000
Practice expense0.92× 0.8890.8179
Malpractice0.07× 0.9150.0641
Total RVUs1.6819
Conversion factor× 33.4009

Office rate, Kentucky$56.18

Office: (0.8 × 1 + 0.92 × 0.889 + 0.07 × 0.915) × $33.4009 = $56.18

Facility: (0.8 × 1 + 0.18 × 0.889 + 0.07 × 0.915) × $33.4009 = $34.20

Open 95972 in the RVU calculator

Payment rules and modifiers for 95972

95972 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 · 95972

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$59.79

Non-facility (office)
$59.79
Facility
$35.07

Higher because the practice carries its own overhead.

Codes related to 95972

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 95972
CodeHow it relatesOffice range, Kentucky
Used instead
95970Neurostimulator analysis, without programmingUsed for implanted neurostimulator analysis when no reprogramming is performed.$18.84
95976Stimulator programming, cranial nerve, simpleSimple programming level for an implanted cranial nerve stimulator.$36.53
95977Stimulator programming, cranial nerve, complexComplex programming level for an implanted cranial nerve stimulator.$48.73
Same family
95971Neurostimulator programming, simple spinal/peripheral nerveThe simpler programming level for spinal cord or peripheral nerve systems.$47.79

How 95972 has changed in Kentucky

95972 · Office / nonfacility

$56.18

Effective 2026-10-01

The base rate is $4.69 higher than on 2025-10-01, moving from $51.49 to $56.18 (9.1%).

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

    $51.49changed to$56.18

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.83 changed to 0.92
    • Practice expense GPCI 0.877 changed to 0.889
    • Malpractice GPCI 0.913 changed to 0.915

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $53.00changed to$51.49

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.82 changed to 0.83
    • Malpractice RVU 0.08 changed to 0.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $52.13changed to$53.00

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $53.13changed to$52.13

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.78 changed to 0.82
    • Malpractice RVU 0.10 changed to 0.08
    • Practice expense GPCI 0.873 changed to 0.877
    • Malpractice GPCI 0.870 changed to 0.913

  5. January 1, 2023

    RVU23A

    $53.12changed to$53.13

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.76 changed to 0.78
    • Malpractice RVU 0.09 changed to 0.10
    • Practice expense GPCI 0.869 changed to 0.873
    • Malpractice GPCI 0.827 changed to 0.870

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $53.56changed to$53.12

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $54.57changed to$53.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.73 changed to 0.76
    • Practice expense GPCI 0.874 changed to 0.869
    • Malpractice GPCI 0.823 changed to 0.827

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $54.66changed to$54.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.74 changed to 0.73
    • Malpractice RVU 0.08 changed to 0.09
    • Practice expense GPCI 0.880 changed to 0.874
    • Malpractice GPCI 0.819 changed to 0.823

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $56.19changed to$54.66

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.79 changed to 0.74

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $55.24changed to$56.19

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.77 changed to 0.79
    • Practice expense GPCI 0.876 changed to 0.880
    • Malpractice GPCI 0.807 changed to 0.819

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $54.96changed to$55.24

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.872 changed to 0.876
    • Malpractice GPCI 0.795 changed to 0.807

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $52.37changed to$54.96

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.69 changed to 0.77
    • Malpractice RVU 0.07 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $52.11changed to$52.37

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $102.32changed to$52.11

    • Conversion factor 35.8228 changed to 35.7547
    • Work RVU 1.50 changed to 0.80
    • Practice expense RVU 1.44 changed to 0.69
    • Malpractice RVU 0.13 changed to 0.07
    • Malpractice GPCI 0.774 changed to 0.795

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $101.73changed to$102.32

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.59 changed to 1.44
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.871 changed to 0.872
    • Malpractice GPCI 0.752 changed to 0.774

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $101.73

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$56.18$34.20RVU26D
2026-07-01$56.18$34.20RVU26C
2026-04-01$56.18$34.20RVU26B
2026-01-01$56.18$34.20RVU26A
2025-10-01$51.49$36.74RVU25D
2025-07-01$51.49$36.74RVU25C
2025-04-01$51.49$36.74RVU25B
2025-01-01$51.49$36.74RVU25A
2024-10-01$53.00$38.11RVU24D
2024-07-01$53.00$38.11RVU24C
2024-04-01$53.00$38.11RVU24B
2024-03-09$53.00$38.11RVU24AR
2024-01-01$52.13$37.49RVU24A
2023-10-01$53.13$38.93RVU23D
2023-07-01$53.13$38.93RVU23C
2023-04-01$53.13$38.93RVU23B
2023-01-01$53.13$38.93RVU23A
2022-10-01$53.12$39.28RVU22D
2022-07-01$53.12$39.28RVU22C
2022-04-01$53.12$39.28RVU22B
2022-01-01$53.12$39.28RVU22A
2021-10-01$53.56$39.91RVU21D
2021-07-01$53.56$39.91RVU21C
2021-04-01$53.56$39.91RVU21B
2021-01-01$53.56$39.91RVU21A
2020-10-01$54.57$41.01RVU20D
2020-07-01$54.57$41.01RVU20C
2020-04-01$54.57$41.01RVU20B
2020-01-01$54.57$41.01RVU20A
2019-10-01$54.66$41.02RVU19D
2019-07-01$54.66$41.02RVU19C
2019-04-01$54.66$41.02RVU19B
2019-01-01$54.66$41.02RVU19A
2018-10-01$56.19$40.98RVU18D
2018-07-01$56.19$40.98RVU18C
2018-04-01$56.19$40.98RVU18B
2018-01-01$56.19$40.98RVU18AR1
2017-10-01$55.24$40.77RVU17D
2017-07-01$55.24$40.77RVU17C
2017-04-01$55.24$40.77RVU17B
2017-01-01$55.24$40.77RVU17A
2016-10-01$54.96$40.60RVU16D
2016-07-01$54.96$40.60RVU16C
2016-04-01$54.96$40.60RVU16B
2016-01-01$54.96$40.60RVU16A
2015-10-01$52.37$40.46RVU15D
2015-07-01$52.37$40.46RVU15C
2015-04-01$52.11$40.26RVU15B
2015-01-01$52.11$40.26RVU15A
2014-10-01$102.32$75.77RVU14D
2014-07-01$102.32$75.77RVU14C
2014-04-01$102.32$75.77RVU14B
2014-01-01$102.32$75.77RVU14A
2013-10-01$101.73$73.58RVU13D
2013-07-01$101.73$73.58RVU13C
2013-04-01$101.73$73.58RVU13B
2013-01-01$101.73$73.58RVU13AR

Price 95972 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

95972 billing questions

How does 95972 differ from 95971?

Both cover programming of spinal cord or peripheral nerve stimulators. Report 95972 for complex programming, generally involving changes to more than three parameters; 95971 is the simpler level.

Can 95972 be reported when settings are only checked?

No. 95972 describes programming, so settings must be changed. For analysis without reprogramming, consider 95970.

Is 95972 used for cranial nerve stimulators?

No. It is for spinal cord or peripheral nerve systems. Cranial nerve stimulator programming is represented by the separate 95976 and 95977 levels.

How many units should be reported for a programming session?

Report one unit for the complex programming service, not a separate unit for each parameter changed.

What documentation supports complex programming?

Record the implanted system and site, the reason for adjustment, the settings evaluated and changed, and the patient’s response. The record should support the complex level selected.

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 95972PPRRVU2026_Oct_nonQPP.csv, line 12,727 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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