$287.19
Choose 95958 for functional brain mapping using EEG. Choose 95957 when the documented service is digital EEG analysis, such as analysis for epileptic spikes.
On this page
CMS RVU26D · Effective 2026-10-01
95958 Brain mapping Medicare reimbursement rates in Iowa
Reports EEG-based functional brain mapping used to evaluate brain activity and support localization or functional assessment, including in selected epilepsy evaluations. Compare 95958 office and facility rates across CMS payment localities in Iowa.
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 95958 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$706.44
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
No 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.
Neurologic diagnostic testing
About 95958: EEG-based functional brain mapping
Reports EEG-based functional brain mapping used to evaluate brain activity and support localization or functional assessment, including in selected epilepsy evaluations.
This service evaluates brain activity with EEG as part of functional mapping, rather than simply recording a routine EEG or analyzing an EEG digitally. Neurologists and other clinicians involved in neurodiagnostic testing may use it when functional information is needed for a focused neurologic assessment, including selected presurgical epilepsy evaluations. The clinical record should identify the mapping purpose and the EEG-based service performed.
Report 95958 when the documented service is functional brain mapping using EEG, not merely digital EEG analysis, drug-activated monitoring, or EEG performed during surgery. The record should support the clinical indication and the mapping work. CMS recognizes a professional component for interpretation, reported with modifier 26, and a technical component for equipment and staff, reported with modifier TC. Billing without either modifier represents the global service.
CMS billing rules for 95958
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU4.13 · 18%
- Practice expense (office) RVU18.48 · 81%
- Malpractice RVU0.28 · 1%
46
Medicare services in 2024 · #5408 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.
95958 compared with similar codes
Office rates for Iowa, from the same CMS release.
$182.84
95955 applies to EEG monitoring during surgery. 95958 describes functional brain mapping and is not selected solely because the evaluation occurs in an operative setting.
$336.07
95961 is brain mapping performed through electrical stimulation. 95958 is the EEG-based functional mapping service.
$351.37
95954 describes EEG monitoring with drug administration. Use 95958 when the documented service is functional brain mapping, not pharmacologic activation of EEG monitoring.
Compare 95958 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.
1 of 1 payment localities
Iowa →
Office / nonfacility
$706.44
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95958 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
12,707
- Code
- 95958
- Physician work
- 4.13
- Practice expense
- 18.48
- Malpractice
- 0.28
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.13 | × 1.000 | 4.1300 |
| Practice expense | 18.48 | × 0.915 | 16.9092 |
| Malpractice | 0.28 | × 0.397 | 0.1112 |
| Total RVUs | 21.1504 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$706.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.13 | 1 |
| Practice expense | 18.48 | 0.915 |
| Malpractice | 0.28 | 0.397 |
(4.13 × 1 + 18.48 × 0.915 + 0.28 × 0.397) × $33.4009 = $706.44
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
95958 billing questions
How is 95958 different from 95957?
95958 represents EEG-based functional brain mapping. 95957 is for digital EEG analysis, such as analysis directed at identifying epileptic spikes; use the code that matches the service documented.
Which modifiers identify the professional and technical portions?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. An unmodified claim represents the global service.
Can 95958 be used for EEG performed during surgery?
Use 95955 when the service is EEG monitoring during surgery. 95958 describes functional brain mapping, not the operative setting by itself.
How does 95958 differ from electrical stimulation mapping?
95958 is EEG-based functional mapping. 95961 describes brain mapping by electrical stimulation, so the documented mapping method distinguishes the services.
What documentation supports reporting 95958?
Document the clinical reason for functional mapping and the EEG-based mapping service performed. A record describing only routine EEG recording or digital analysis does not establish this service.
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.
12,70495957,,Eeg digital analysis,A,,1.93,7.24,,7.24,NA,0.11,9.28,9.28,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,70595957,26,Eeg digital analysis,A,,1.93,1.04,,1.04,,0.07,3.04,3.04,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,70695957,TC,Eeg digital analysis,A,,0.00,6.20,,6.20,NA,0.04,6.24,6.24,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,70795958,,Eeg monitoring/function test,A,,4.13,18.48,,18.48,NA,0.28,22.89,22.89,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,70895958,26,Eeg monitoring/function test,A,,4.13,2.41,,2.41,,0.20,6.74,6.74,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,70995958,TC,Eeg monitoring/function test,A,,0.00,16.07,,16.07,NA,0.08,16.15,16.15,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,71095961,,Electrode stimulation brain,A,,2.97,7.59,,7.59,NA,0.37,10.93,10.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136