CPT code 95813: EEG recording2026 Medicare rate & RVUs

Medicare pays $479.64 for 95813 nationally in the office. Local office rates run $418.31–$669.93.

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

What 95813 covers

This service covers an extended scalp electroencephalogram recording, with cerebral electrical activity acquired for 61 through 119 minutes. It may be used when a clinician needs a longer diagnostic sample, such as when evaluating suspected seizures, spells of altered awareness, or abnormal mental status. An EEG technologist typically applies the electrodes and acquires the tracing in an outpatient EEG laboratory or hospital; a qualified physician reviews and interprets it.

Select the code from the actual EEG recording duration, not the appointment length or interpretation time. A 41–60-minute recording falls under 95812; other EEG codes may be selected based on the recorded sleep or wake state or clinical circumstance. Documentation should identify the indication, recording duration, technical circumstances, and physician interpretation. CMS recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or no component modifier 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 95813 pays more and less

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

109 of 109 payment localities

95813 rates by state

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

How the 95813 rate is calculated

Each of 95813’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.

Payment rules and modifiers for 95813

The CMS indicators that decide how 95813 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

95813 compared with similar codes

How to choose

95812EEG monitoring

This code covers 61–119 minutes of EEG recording; 95812 covers the shorter 41–60-minute duration.

95816EEG

95816 identifies an EEG capturing awake and drowsy states. Choose 95813 based on its 61–119-minute recording duration.

95819EEG

95819 identifies an EEG capturing awake and asleep states. 95813 is selected for a 61–119-minute recording.

95822EEG

95822 is for an EEG performed in coma or during sleep only; 95813 is distinguished by a 61–119-minute recording.

Codes related to 95813

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

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

Open CMS sourceHow we calculate rates