Billing code 95954: EEG activationMedicare rate & RVUs

Medicare pays $379.43 for 95954 nationally in the office. Local office rates run $335.47–$516.10.

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

What 95954 covers

This service involves using a medication during EEG testing to provoke or enhance electrical findings relevant to the diagnostic question, often in seizure evaluation. A neurologist or other qualified physician directs the provocation and interprets the tracing; an EEG technologist typically applies electrodes and operates the recording equipment. It may be performed in an outpatient EEG laboratory or during a hospital-based diagnostic evaluation. The medication-related activation is distinct from simply recording a patient who takes their usual medication.

Report the service when the record supports a deliberate medication-based activation during EEG testing, including the clinical purpose, medication administered, and resulting EEG observations. CMS recognizes professional and technical portions: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The professional and technical portions are separately priced in the CMS fee schedule. The documentation should connect the medication administration to the EEG procedure rather than describe medication management alone.

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 95954 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

95954 rates by state

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

How the 95954 rate is calculated

Each of 95954’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 95954

The CMS indicators that decide how 95954 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

95954 compared with similar codes

How to choose

95816EEG

This code concerns medication used to provoke EEG findings. Code 95816 describes a routine awake or drowsy EEG without that activation.

95819EEG

Code 95819 describes a routine EEG with awake and asleep recording. Choose this code when the distinguishing service is medication-based activation during EEG testing.

95955Intraoperative EEG

Code 95955 is for EEG monitoring during surgery. This code concerns medication-based activation in diagnostic EEG testing, not intraoperative monitoring.

95957EEG analysis

Code 95957 represents digital analysis of EEG data. This code represents medication-based activation; analysis alone does not establish that activation service.

Codes related to 95954

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