$335.88
95961 reports the primary functional mapping service; 95962 reports additional mapping time and must be paired with it.
On this page
CMS RVU26D · Effective 2026-10-01
95962 Brain mapping Medicare reimbursement rates in Kentucky
Reports additional-hour functional brain mapping during cortical or subcortical stimulation when mapping continues beyond the primary service. Compare 95962 office and facility rates across CMS payment localities in Kentucky.
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 95962 in Kentucky?
Kentucky 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
$285.99
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Intraoperative neurophysiology
About 95962: Additional-hour functional brain mapping
Reports additional-hour functional brain mapping during cortical or subcortical stimulation when mapping continues beyond the primary service.
This add-on represents continued functional mapping during brain surgery, using stimulation or recording from electrodes on the brain surface or depth electrodes to identify areas involved in functions such as movement or language. It may be performed during procedures such as an awake craniotomy for a brain tumor or epilepsy surgery, with the surgeon or a neurophysiology professional assessing responses to stimulation and documenting the functional findings.
Report 95962 only with the primary mapping service, 95961, for documented additional mapping time; it is not a stand-alone service. CMS treats it as paid within the primary procedure’s global period. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment-and-staff component, and no modifier represents the global service. Documentation should support the mapping performed, the functional findings, and the additional time reported.
CMS billing rules for 95962
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- 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 RVU3.21 · 35%
- Practice expense (office) RVU5.65 · 61%
- Malpractice RVU0.36 · 4%
1.4K
Medicare services in 2024 · #2728 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.
95962 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
95940 describes time-based intraoperative neurophysiologic monitoring in the operating room, not additional functional cortical or subcortical mapping.
$358.92
95938 reports somatosensory evoked-potential testing, rather than stimulation-based functional mapping of brain areas.
Compare 95962 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
Kentucky →
Office / nonfacility
$285.99
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 95962 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
12,713
- Code
- 95962
- Physician work
- 3.21
- Practice expense
- 5.65
- Malpractice
- 0.36
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.21 | × 1.000 | 3.2100 |
| Practice expense | 5.65 | × 0.889 | 5.0229 |
| Malpractice | 0.36 | × 0.915 | 0.3294 |
| Total RVUs | 8.5622 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$285.99
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.21 | 1 |
| Practice expense | 5.65 | 0.889 |
| Malpractice | 0.36 | 0.915 |
(3.21 × 1 + 5.65 × 0.889 + 0.36 × 0.915) × $33.4009 = $285.99
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.
95962 billing questions
When should 95962 be reported instead of 95961?
95961 reports the primary functional mapping service. Report 95962 for documented additional mapping time beyond that primary service.
Can 95962 be billed by itself?
No. It is an add-on code reported with 95961 and is paid within that primary procedure’s global period.
Which modifier identifies the interpretation?
Modifier 26 identifies the professional component, including interpretation. Modifier TC identifies the technical component; billing without either modifier represents the global service.
What documentation supports reporting additional mapping time?
Document the stimulation or recording performed, the functional responses or findings, and the additional mapping time that supports 95962.
Can evoked-potential monitoring be reported with brain mapping?
Codes such as 95938 or 95939 may describe distinct evoked-potential monitoring performed during the same surgery. The record should support each service separately.
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.
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12,71195961,26,Electrode stimulation brain,A,,2.97,1.76,,1.76,,0.35,5.08,5.08,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,71295961,TC,Electrode stimulation brain,A,,0.00,5.83,,5.83,NA,0.02,5.85,5.85,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,71395962,,Electrode stim brain add-on,A,,3.21,5.65,,5.65,NA,0.36,9.22,9.22,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,71495962,26,Electrode stim brain add-on,A,,3.21,1.89,,1.89,,0.34,5.44,5.44,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,71595962,TC,Electrode stim brain add-on,A,,0.00,3.76,,3.76,NA,0.02,3.78,3.78,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,71695965,,Meg spontaneous,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631