$19.66–$21.12
Use 95970 for analysis of an implanted spinal cord or peripheral nerve neurostimulator without programming. Use 95971 when simple programming adjustments are made.
On this page
CMS RVU26D · Effective 2026-10-01
95971 Neurostimulator programming Medicare reimbursement rates in Illinois
Report this service when an implanted spinal cord or peripheral nerve neurostimulator is analyzed and its settings receive simple programming adjustments. Compare 95971 office and facility rates across CMS payment localities in Illinois.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95971 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$49.83–$53.76
4 of 4 localities have a supported rate.
Facility setting
$35.20–$37.64
4 of 4 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 95971 pays more and less in Illinois
4 payment localities
$49.83 to $53.76
Neuromodulation
About 95971: Simple spinal or peripheral stimulator programming
Report this service when an implanted spinal cord or peripheral nerve neurostimulator is analyzed and its settings receive simple programming adjustments.
Code 95971 describes analysis and simple programming of an implanted neurostimulator used for spinal cord or peripheral nerve stimulation. A clinician managing the device uses a programmer to review its operation and make simple setting adjustments. Common settings include pain-management clinics and follow-up visits for patients with implanted spinal cord stimulators for chronic pain or peripheral nerve stimulators.
Choose this code when the device stimulates the spinal cord or a peripheral nerve and programming is performed. Use 95970 when the device is analyzed without programming, and 95972 when programming is complex. Documentation should identify the device and stimulation site, the findings reviewed, the settings changed, and the patient's response. Do not report a no-change device check as programming. The CMS fee schedule assigns work, practice-expense, and malpractice values, with different practice-expense values for office and facility settings.
Where the value comes from
- Work RVU0.78 · 52%
- Practice expense (office) RVU0.66 · 44%
- Malpractice RVU0.07 · 5%
18.2K
Medicare services in 2024 · #1186 by national volume
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.
95971 compared with similar codes
Office rates for Illinois, from the same CMS release.
$58.43–$63.16
This code is for complex programming of a spinal cord or peripheral nerve neurostimulator; 95971 is for simple programming of those devices.
$38.13–$40.90
95976 covers simple programming of an implanted cranial nerve neurostimulator. Choose 95971 for a spinal cord or peripheral nerve system.
Compare 95971 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
4 of 4 payment localities
Chicago →
Office / nonfacility
$53.76
Facility
$37.64
East St. Louis →
Office / nonfacility
$51.04
Facility
$36.29
Rest Of Illinois →
Office / nonfacility
$49.83
Facility
$35.20
Suburban Chicago →
Office / nonfacility
$53.02
Facility
$36.55
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95971 billing questions
When should 95971 be used instead of 95970?
Use 95971 when simple programming adjustments are made to an implanted spinal cord or peripheral nerve neurostimulator. Use 95970 for device analysis without programming.
How is 95971 distinguished from 95972?
Both apply to spinal cord or peripheral nerve neurostimulators, but 95971 represents simple programming and 95972 represents complex programming. The record should support the level of programming performed.
Can 95970 be reported for the analysis during a 95971 service?
95971 includes analysis with programming. Do not separately report 95970 for the same device analysis performed as part of that programming service.
What documentation supports 95971?
Document the implanted device and stimulation site, the pre-adjustment assessment, the settings changed, and the patient's response. The note should support that programming was performed and was simple.
Does 95971 apply to an implanted vagus nerve stimulator?
No. For cranial nerve neurostimulator programming, the simple-programming code is 95976; 95971 is for spinal cord or peripheral nerve stimulation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,72395967,26,Meg evoked each addl,A,,3.40,1.98,,1.98,,0.16,5.54,5.54,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,72495967,TC,Meg evoked each addl,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,72595970,,Alys npgt w/o prgrmg,A,,0.35,0.21,,0.10,,0.03,0.59,0.48,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,72695971,,Alys smpl sp/pn npgt w/prgrm,A,,0.78,0.66,,0.18,,0.07,1.51,1.03,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,72795972,,Alys cplx sp/pn npgt w/prgrm,A,,0.80,0.92,,0.18,,0.07,1.79,1.05,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,72895976,,Alys smpl cn npgt prgrmg,A,,0.71,0.37,,0.18,,0.06,1.14,0.95,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,72995977,,Alys cplx cn npgt prgrmg,A,,0.95,0.49,,0.24,,0.08,1.52,1.27,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00