Billing code 95976: Stimulator programmingMedicare rate & RVUs in Illinois
Report simple programming of an implanted cranial nerve neurostimulator, commonly a vagus nerve stimulator adjusted during epilepsy care.
Medicare pays $38.13–$40.90 for 95976 in the office in Illinois, from Rest Of Illinois to Chicago. 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 95976 covers
Code 95976 covers a programming visit for an implanted cranial nerve neurostimulator, most commonly a vagus nerve stimulator used to manage epilepsy. The clinician interrogates the pulse generator, reviews device function and settings, and makes a simple adjustment to the stimulation program. Neurologists and epileptologists commonly perform this work in an outpatient neurology or epilepsy clinic; programming may also occur in a hospital setting when clinically needed.
Report 95976 when simple programming is performed on a cranial nerve device. Documentation should identify the device, the programming performed, settings assessed or changed, and the clinical reason for adjustment. The analysis needed to carry out programming is part of this service, rather than a separate 95970 line for the same work. Use 95970 when the device is analyzed without programming, and 95977 for complex cranial nerve programming. CMS assigns work, practice-expense, and malpractice RVUs to the service; FeeBase displays payment rates separately.
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 95976 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$38.13 to $40.90
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $40.90 | $34.52 |
| East St. Louis | $39.12 | $33.28 |
| Rest Of Illinois | $38.13 | $32.34 |
| Suburban Chicago | $40.12 | $33.61 |
How the 95976 rate is calculated
Each of 95976’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 · 95976
RVUs × geographic indexes × conversion factor
Work0.71
0.71 RVUs× 1.000 GPCI
Practice expense0.37
0.37 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
1.1400
Conversion factor
$33.4009
Medicare rate
$38.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95976
95976 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 95976
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$38.08
- Non-facility (office)
- $38.08
- Facility
- $31.73
Higher because the practice carries its own overhead.
95976 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95970Neurostimulator analysis
- 95970 describes analysis without programming. Use 95976 when simple programming of a cranial nerve neurostimulator is performed.
- 95977Stimulator programming
- 95977 is the complex-programming sibling for a cranial nerve neurostimulator; 95976 represents the simple programming level.
- 95971Neurostimulator programming
- 95971 is for simple programming of a spinal or peripheral nerve neurostimulator. 95976 applies to a cranial nerve device, such as a vagus nerve stimulator.
- 95983Brain stimulator programming
- 95983 is for programming a brain neurostimulator. Choose 95976 for a cranial nerve neurostimulator instead.
95976 billing questions
How does 95976 differ from 95977?
Both describe programming of a cranial nerve neurostimulator. Select 95976 for simple programming and 95977 when the documented programming meets the complex level.
Can 95970 also be reported for the same programming session?
The analysis needed to perform the programming is included in 95976. Do not report 95970 separately for that same analysis work.
Which device is most commonly associated with 95976?
A vagus nerve stimulator used in epilepsy care is a common example. The code is for programming a cranial nerve neurostimulator, not a spinal or peripheral nerve stimulator.
Is 95976 based on programming time or individual settings?
It is not described as a timed service or as a per-setting code. Document the programming performed and report the applicable service level.
What documentation supports reporting 95976?
Document the implanted cranial nerve device, the reason for the visit, device assessment, and the programming changes or other programming work 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
Show the CMS file lines behind this rate
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