Billing code 95822: EEGMedicare rate & RVUs in Florida
Reports an EEG recorded only during sleep or coma, such as when evaluating seizures or abnormal brain function in a patient who is not awake.
Medicare pays $430.61–$468.76 for 95822 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 95822 covers
Code 95822 describes an electroencephalogram recorded while the patient is asleep or comatose, rather than an awake-and-asleep routine EEG. Scalp electrodes and EEG equipment capture cerebral electrical activity; an EEG technologist generally performs the recording, and a physician with EEG expertise interprets it. Hospital and outpatient neurodiagnostic services may use this code when the documented recording is limited to sleep or coma, including evaluations of seizures or abnormal brain function.
Choose the code based on the recording state, not just the reason for testing. An EEG that includes awake and asleep phases is reported with 95819; an awake-and-drowsy study is reported with 95816. Documentation should support the patient's state during the recording and the EEG services performed. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the professional component, modifier TC for the technical component, or neither 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 95822 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$430.61 to $468.76
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $454.91 | Unavailable |
| Miami | $468.76 | Unavailable |
| Rest Of Florida | $430.61 | Unavailable |
How the 95822 rate is calculated
Each of 95822’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 · 95822
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.05Practice expense 12.23Malpractice 0.10
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95822
The CMS indicators that decide how 95822 is paid alongside other services.
CMS payment indicators · 95822
EEG
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95822 without 26 · national office
$446.90
EEG
95822-26 · Professional component
$56.78
Pays only the interpretation and report.
95822 compared with similar codes
Compare codes
95822 vs 95816 vs 95819 vs 95812 vs 95813: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95816EEG
- Use 95822 for recording limited to sleep or coma. Use 95816 when the EEG includes awake and drowsy recording.
- 95819EEG
- Use 95822 for sleep-only or coma-only recording; 95819 describes an EEG that captures both awake and asleep phases.
- 95812EEG monitoring
- 95812 identifies an EEG by its 41-to-60-minute duration. 95822 is distinguished by sleep-only or coma-only recording.
- 95813EEG recording
- 95813 identifies an extended EEG lasting 61 to 119 minutes. 95822 is distinguished by the patient's state during recording.
95822 billing questions
How does 95822 differ from 95819?
95822 is for an EEG recorded during sleep or coma only. Use 95819 when the study includes both awake and asleep recording.
How does 95822 differ from 95816?
95822 describes sleep-only or coma-only recording. Code 95816 is for an EEG that includes awake and drowsy recording.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff; billing without either modifier represents the global service.
Is the code selected by recording duration?
The distinguishing feature of 95822 is that recording is limited to sleep or coma. Codes 95812 and 95813 identify EEGs by recording duration.
What should the record support?
Document that the EEG was recorded during sleep or coma, along with the recording performed and the physician's interpretation.
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
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