CPT code 95977: Stimulator programming, cranial nerve, complex2026 Medicare rate & RVUs in Iowa
Reports complex programming of an implanted cranial nerve neurostimulator, such as a vagus nerve stimulator, when more than three parameters are programmed.
In Iowa, Medicare pays $47.77 for 95977 in the office and $40.13 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 95977 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 95977 covers
This service covers analysis and programming of an implanted cranial nerve neurostimulator, most commonly a vagus nerve stimulator used in epilepsy care. During a device-management visit, a neurologist, epileptologist, neurosurgeon, or other qualified clinician may interrogate the system, assess its function, and adjust stimulation settings using the device programmer. The service is performed in settings where the patient’s implanted system can be evaluated and programmed, including an outpatient clinic.
Choose this code when the clinician programs more than three parameters; the parameter count, not a subjective impression of difficulty, distinguishes complex from simple cranial nerve programming. The record should identify the device and document its evaluation, the programmed parameters and changes, and the clinical reason for adjustment. CMS assigns physician-work and practice-expense values to the service, with distinct office and facility practice-expense inputs.
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 Iowa compares for 95977
Across 109 of 109 payment localities, the office rate for 95977 runs from $47.17 in Arkansas to $66.50 in Alaska. Iowa pays $47.77. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$47.77
- Los Angeles, CA · California$54.17+$6.40
- Washington, DC area · District of Columbia$55.70+$7.93
- Miami, FL · Florida$55.53+$7.76
- Chicago, IL · Illinois$54.53+$6.76
- Manhattan, NY · New York$57.02+$9.25
- Alaska · Alaska$66.50+$18.73
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $47.56 | $40.26 |
| ArkansasArkansas | $47.17 | $39.99 |
| ArizonaArizona | $49.88 | $41.79 |
| Bakersfield, CACalifornia | $51.90 | $42.75 |
| Chico, CACalifornia | $51.64 | $42.49 |
| El Centro, CACalifornia | $51.65 | $42.50 |
| Fresno, CACalifornia | $51.64 | $42.49 |
| Hanford, CACalifornia | $51.64 | $42.49 |
| Madera, CACalifornia | $51.64 | $42.49 |
| Merced, CACalifornia | $51.64 | $42.49 |
| Modesto, CACalifornia | $51.64 | $42.49 |
| Napa, CACalifornia | $56.66 | $45.65 |
| Oxnard, CACalifornia | $53.63 | $43.76 |
| Redding, CACalifornia | $51.64 | $42.49 |
| Rest of CaliforniaCalifornia | $51.64 | $42.49 |
| Riverside, CACalifornia | $52.52 | $43.37 |
| Sacramento, CACalifornia | $53.34 | $43.63 |
| Salinas, CACalifornia | $53.12 | $43.44 |
| San Diego, CACalifornia | $53.71 | $43.72 |
| Marin County, CACalifornia | $59.05 | $47.27 |
| San Francisco, CACalifornia | $58.96 | $47.18 |
| San Benito County, CACalifornia | $60.25 | $48.21 |
| Santa Clara County, CACalifornia | $59.88 | $47.84 |
| San Luis Obispo, CACalifornia | $52.34 | $42.83 |
| Santa Cruz, CACalifornia | $53.71 | $43.57 |
| Santa Maria, CACalifornia | $53.13 | $43.40 |
| Santa Rosa, CACalifornia | $54.21 | $43.96 |
| Stockton, CACalifornia | $51.64 | $42.49 |
| Vallejo, CACalifornia | $56.53 | $45.52 |
| Visalia, CACalifornia | $51.64 | $42.49 |
| Yuba City, CACalifornia | $51.64 | $42.49 |
| ColoradoColorado | $51.61 | $42.73 |
| ConnecticutConnecticut | $53.23 | $44.23 |
| DelawareDelaware | $50.46 | $42.21 |
| Fort Lauderdale, FLFlorida | $53.14 | $44.68 |
| Rest of FloridaFlorida | $51.39 | $43.41 |
| Atlanta, GAGeorgia | $51.66 | $43.18 |
| Rest of GeorgiaGeorgia | $49.51 | $42.07 |
| Hawaii, Guam, HIHawaii | $51.89 | $42.39 |
| IdahoIdaho | $48.05 | $40.37 |
| East St. Louis, ILIllinois | $52.17 | $44.49 |
| Rest of IllinoisIllinois | $50.85 | $43.23 |
| Suburban Chicago, ILIllinois | $53.50 | $44.92 |
| IndianaIndiana | $48.20 | $40.46 |
| KansasKansas | $47.87 | $40.32 |
| KentuckyKentucky | $48.73 | $41.30 |
| New Orleans, LALouisiana | $50.17 | $42.31 |
| Rest of LouisianaLouisiana | $48.78 | $41.39 |
| Metropolitan Boston, MAMassachusetts | $54.95 | $44.98 |
| Rest of MassachusettsMassachusetts | $51.60 | $42.81 |
| Baltimore area, MDMaryland | $53.11 | $44.15 |
| Rest of MarylandMaryland | $51.06 | $42.61 |
| Rest of MaineMaine | $48.45 | $40.77 |
| Southern Maine, MEMaine | $49.64 | $41.36 |
| Detroit, MIMichigan | $52.03 | $43.97 |
| Rest of MichiganMichigan | $49.69 | $42.07 |
| MinnesotaMinnesota | $49.36 | $40.77 |
| Metropolitan Kansas City, MOMissouri | $49.71 | $41.87 |
| Metropolitan St. Louis, MOMissouri | $49.99 | $42.04 |
| Rest of MissouriMissouri | $48.44 | $41.24 |
| MississippiMississippi | $47.80 | $40.61 |
| MontanaMontana | $50.76 | $42.41 |
| North CarolinaNorth Carolina | $48.71 | $40.92 |
| North DakotaNorth Dakota | $49.18 | $40.83 |
| NebraskaNebraska | $47.85 | $40.14 |
| New HampshireNew Hampshire | $51.11 | $42.41 |
| Northern New JerseyNew Jersey | $55.57 | $45.88 |
| Rest of New JerseyNew Jersey | $53.80 | $44.69 |
| New MexicoNew Mexico | $49.95 | $42.29 |
| NevadaNevada | $50.34 | $41.98 |
| NYC suburbs and Long Island, NYNew York | $58.18 | $48.25 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $54.31 | $45.17 |
| Queens, NYNew York | $56.96 | $47.09 |
| Rest of New YorkNew York | $49.16 | $41.22 |
| OhioOhio | $49.37 | $41.74 |
| OklahomaOklahoma | $48.42 | $40.97 |
| Portland, OROregon | $52.41 | $43.13 |
| Rest of OregonOregon | $49.91 | $41.59 |
| Metropolitan Philadelphia, PAPennsylvania | $52.53 | $43.83 |
| Rest of PennsylvaniaPennsylvania | $49.28 | $41.61 |
| Puerto RicoPuerto Rico | $50.91 | $42.47 |
| Rhode IslandRhode Island | $51.62 | $43.00 |
| South CarolinaSouth Carolina | $49.12 | $41.41 |
| South DakotaSouth Dakota | $49.00 | $40.64 |
| TennesseeTennessee | $48.04 | $40.45 |
| Austin, TXTexas | $51.48 | $42.64 |
| Beaumont, TXTexas | $49.11 | $41.51 |
| Brazoria, TXTexas | $50.29 | $42.01 |
| Dallas, TXTexas | $50.61 | $42.29 |
| Fort Worth, TXTexas | $50.48 | $42.25 |
| Galveston, TXTexas | $50.45 | $42.16 |
| Houston, TXTexas | $51.91 | $43.62 |
| Rest of TexasTexas | $49.68 | $41.75 |
| UtahUtah | $49.51 | $41.67 |
| VirginiaVirginia | $49.71 | $41.50 |
| Virgin Islands, VIUnited States Virgin Islands | $50.91 | $42.47 |
| VermontVermont | $49.29 | $41.02 |
| Rest of WashingtonWashington | $51.41 | $42.62 |
| King County, WAWashington | $55.58 | $45.34 |
| WisconsinWisconsin | $48.23 | $40.23 |
| West VirginiaWest Virginia | $49.78 | $42.52 |
| WyomingWyoming | $50.07 | $41.72 |
95977 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$47.17
$66.50
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $66.50 | 1 |
| AL | $47.56 | 1 |
| AR | $47.17 | 1 |
| AZ | $49.88 | 1 |
| CA | $51.64–$60.25 | 29 |
| CO | $51.61 | 1 |
| CT | $53.23 | 1 |
| DC | $55.70 | 1 |
| DE | $50.46 | 1 |
| FL | $51.39–$55.53 | 3 |
| GA | $49.51–$51.66 | 2 |
| GU | $51.89 | 1 |
| HI | $51.89 | 1 |
| IA | $47.77 | 1 |
| ID | $48.05 | 1 |
| IL | $50.85–$54.53 | 4 |
| IN | $48.20 | 1 |
| KS | $47.87 | 1 |
| KY | $48.73 | 1 |
| LA | $48.78–$50.17 | 2 |
| MA | $51.60–$54.95 | 2 |
| MD | $51.06–$55.70 | 3 |
| ME | $48.45–$49.64 | 2 |
| MI | $49.69–$52.03 | 2 |
| MN | $49.36 | 1 |
| MO | $48.44–$49.99 | 3 |
| MS | $47.80 | 1 |
| MT | $50.76 | 1 |
| NC | $48.71 | 1 |
| ND | $49.18 | 1 |
| NE | $47.85 | 1 |
| NH | $51.11 | 1 |
| NJ | $53.80–$55.57 | 2 |
| NM | $49.95 | 1 |
| NV | $50.34 | 1 |
| NY | $49.16–$58.18 | 5 |
| OH | $49.37 | 1 |
| OK | $48.42 | 1 |
| OR | $49.91–$52.41 | 2 |
| PA | $49.28–$52.53 | 2 |
| PR | $50.91 | 1 |
| RI | $51.62 | 1 |
| SC | $49.12 | 1 |
| SD | $49.00 | 1 |
| TN | $48.04 | 1 |
| TX | $49.11–$51.91 | 8 |
| UT | $49.51 | 1 |
| VA | $49.71–$55.70 | 2 |
| VI | $50.91 | 1 |
| VT | $49.29 | 1 |
| WA | $51.41–$55.58 | 2 |
| WI | $48.23 | 1 |
| WV | $49.78 | 1 |
| WY | $50.07 | 1 |
How the 95977 rate is calculated
Each of 95977’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 · 95977
RVUs × geographic indexes × conversion factor
Work0.95
0.95 RVUs× 1.000 GPCI
Practice expense0.49
0.49 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
1.5200
Conversion factor
$33.4009
Medicare rate
$50.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,729
- Code
- 95977
- Physician work
- 0.95
- Practice expense
- 0.49
- Malpractice
- 0.08
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.95 | × 1.000 | 0.9500 |
| Practice expense | 0.49 | × 0.915 | 0.4484 |
| Malpractice | 0.08 | × 0.397 | 0.0318 |
| Total RVUs | 1.4301 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$47.77
Office: (0.95 × 1 + 0.49 × 0.915 + 0.08 × 0.397) × $33.4009 = $47.77
Facility: (0.95 × 1 + 0.24 × 0.915 + 0.08 × 0.397) × $33.4009 = $40.13
Payment rules and modifiers for 95977
95977 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 · 95977
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$50.77
- Non-facility (office)
- $50.77
- Facility
- $42.42
Higher because the practice carries its own overhead.
How 95977 has changed in Iowa
95977 · Office / nonfacility
$47.77
Effective 2026-10-01
The base rate is $1.63 higher than on 2025-10-01, moving from $46.14 to $47.77 (3.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$46.14changed to$47.77
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.97 changed to 0.95
- Practice expense RVU 0.46 changed to 0.49
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$48.70changed to$46.14
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.49 changed to 0.46
- Malpractice RVU 0.10 changed to 0.08
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$47.91changed to$48.70
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$49.48changed to$47.91
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$50.73changed to$49.48
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.50 changed to 0.49
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$51.15changed to$50.73
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$52.10changed to$51.15
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.48 changed to 0.50
- Malpractice RVU 0.09 changed to 0.10
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$52.02changed to$52.10
- Conversion factor 36.0391 changed to 36.0896
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$52.02
Held through RVU19B, RVU19C, RVU19D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $47.77 | $40.13 | RVU26D |
| 2026-07-01 | $47.77 | $40.13 | RVU26C |
| 2026-04-01 | $47.77 | $40.13 | RVU26B |
| 2026-01-01 | $47.77 | $40.13 | RVU26A |
| 2025-10-01 | $46.14 | $45.55 | RVU25D |
| 2025-07-01 | $46.14 | $45.55 | RVU25C |
| 2025-04-01 | $46.14 | $45.55 | RVU25B |
| 2025-01-01 | $46.14 | $45.55 | RVU25A |
| 2024-10-01 | $48.70 | $47.79 | RVU24D |
| 2024-07-01 | $48.70 | $47.79 | RVU24C |
| 2024-04-01 | $48.70 | $47.79 | RVU24B |
| 2024-03-09 | $48.70 | $47.79 | RVU24AR |
| 2024-01-01 | $47.91 | $47.01 | RVU24A |
| 2023-10-01 | $49.48 | $48.86 | RVU23D |
| 2023-07-01 | $49.48 | $48.86 | RVU23C |
| 2023-04-01 | $49.48 | $48.86 | RVU23B |
| 2023-01-01 | $49.48 | $48.86 | RVU23A |
| 2022-10-01 | $50.73 | $49.79 | RVU22D |
| 2022-07-01 | $50.73 | $49.79 | RVU22C |
| 2022-04-01 | $50.73 | $49.79 | RVU22B |
| 2022-01-01 | $50.73 | $49.79 | RVU22A |
| 2021-10-01 | $51.15 | $50.20 | RVU21D |
| 2021-07-01 | $51.15 | $50.20 | RVU21C |
| 2021-04-01 | $51.15 | $50.20 | RVU21B |
| 2021-01-01 | $51.15 | $50.20 | RVU21A |
| 2020-10-01 | $52.10 | $51.44 | RVU20D |
| 2020-07-01 | $52.10 | $51.44 | RVU20C |
| 2020-04-01 | $52.10 | $51.44 | RVU20B |
| 2020-01-01 | $52.10 | $51.44 | RVU20A |
| 2019-10-01 | $52.02 | $51.37 | RVU19D |
| 2019-07-01 | $52.02 | $51.37 | RVU19C |
| 2019-04-01 | $52.02 | $51.37 | RVU19B |
| 2019-01-01 | $52.02 | $51.37 | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
95977 billing questions
How does this differ from 95976?
Use 95977 when more than three parameters are programmed for a cranial nerve neurostimulator. Code 95976 is for programming one to three parameters.
Can this code be used for a spinal cord stimulator?
No. This code is for a cranial nerve neurostimulator, such as a vagus nerve stimulator. The corresponding complex programming code for a spinal cord or peripheral nerve system is 95972.
Does device interrogation without a setting change qualify?
This code describes programming, not analysis alone. For implanted neurostimulator analysis without programming, consider 95970 when its service description fits.
Is the code selected by visit length?
No. The simple-versus-complex distinction is based on the number of parameters programmed, with more than three supporting 95977. Document the parameter count and changes.
What should the note include?
Document the cranial nerve device, its evaluation, the parameters programmed and their resulting settings, and why the adjustment was made.
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
Fee sheets · Coming soon
Put 95977 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist