CPT code 95819: EEG2026 Medicare rate & RVUs

Medicare pays $482.31 for 95819 nationally in the office. Local office rates run $417.98–$680.52.

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

What 95819 covers

A technologist places scalp electrodes and records brain electrical activity during wakefulness and sleep. A physician, commonly a neurologist, interprets the tracing. The study may be performed in an outpatient diagnostic department, clinic, or hospital when a clinician needs to assess events such as suspected seizures or episodes of altered awareness and wants both states represented in the recording.

Choose this code when the EEG includes awake and sleep recording, rather than selecting solely by the patient’s presenting symptom. The report should identify the states captured and include the interpretation; the technical record supports the equipment and staff portion. CMS recognizes separately priced professional and technical components: report modifier 26 for the interpretation and modifier TC for the equipment and staff. Without either modifier, the claim represents 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 95819 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

95819 rates by state

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

How the 95819 rate is calculated

Each of 95819’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 95819

The CMS indicators that decide how 95819 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

95819 compared with similar codes

How to choose

95816EEG

Use 95816 for awake-and-drowsy recording. Use 95819 when the EEG includes sleep recording as well as wakefulness.

95822EEG

95822 describes an EEG recorded only during sleep or coma; 95819 includes both awake and sleep states.

95812EEG monitoring

95812 is associated with a specified recording-duration range. 95819 is distinguished by recording both awake and sleep states.

95813EEG recording

95813 is associated with a longer specified recording-duration range. Select 95819 when the documented service is an awake-and-sleep EEG rather than by duration.

Codes related to 95819

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