$482.14
Choose 95816 for an awake-and-drowsy recording; 95819 applies when the recording includes sleep as well.
On this page
CMS RVU26D · Effective 2026-10-01
95816 EEG Medicare reimbursement rates in Nevada
Reports a routine EEG recording that captures wakefulness and drowsiness, commonly used to evaluate seizures, episodic altered awareness, or other suspected cerebral dysfunction. Compare 95816 office and facility rates across CMS payment localities in Nevada.
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 95816 in Nevada?
Nevada 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
$413.32
1 of 1 localities have a supported rate.
Payment area: Nevada**
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.
Neurology testing
About 95816: Awake and drowsy electroencephalogram
Reports a routine EEG recording that captures wakefulness and drowsiness, commonly used to evaluate seizures, episodic altered awareness, or other suspected cerebral dysfunction.
This service records electrical activity from scalp electrodes while the patient is awake and drowsy. EEG technologists typically apply the electrodes and acquire the tracing in an outpatient neurodiagnostic lab, hospital, or clinic; a neurologist or other qualified physician interprets the results. It is commonly ordered when evaluating suspected seizures, unexplained spells, or changes in awareness. The state captured matters: this code describes an awake-and-drowsy study, not one that documents sleep.
Select the code based on the recording performed, rather than the reason for the referral. The report should identify the recorded states and include the physician’s interpretation. CMS recognizes professional and technical components: modifier 26 represents interpretation, modifier TC represents the equipment and staff, and reporting without either modifier represents the global service. When the professional and technical portions are furnished and billed separately, each portion is reported by the entity that furnished it.
CMS billing rules for 95816
- 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 RVU1.05 · 8%
- Practice expense (office) RVU11.23 · 91%
- Malpractice RVU0.10 · 1%
300.1K
Medicare services in 2024 · #311 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.
95816 compared with similar codes
Office rates for Nevada, from the same CMS release.
$382.95
95812 identifies an EEG by a 41–60 minute recording duration. 95816 identifies the awake-and-drowsy states rather than that duration range.
$479.39
95813 applies to an extended EEG recording of 61–119 minutes. Use 95816 for the awake-and-drowsy study when the extended-duration criteria are not the basis for code selection.
Compare 95816 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
Nevada** →
Office / nonfacility
$413.32
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 95816 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
12,556
- Code
- 95816
- Physician work
- 1.05
- Practice expense
- 11.23
- Malpractice
- 0.10
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.05 | × 1.000 | 1.0500 |
| Practice expense | 11.23 | × 1.001 | 11.2412 |
| Malpractice | 0.10 | × 0.833 | 0.0833 |
| Total RVUs | 12.3745 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nevada**$413.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.05 | 1 |
| Practice expense | 11.23 | 1.001 |
| Malpractice | 0.1 | 0.833 |
(1.05 × 1 + 11.23 × 1.001 + 0.1 × 0.833) × $33.4009 = $413.32
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.
95816 billing questions
How does this differ from 95819?
Use 95816 when the recording captures wakefulness and drowsiness. Use 95819 when the EEG also documents sleep.
Which modifiers identify the EEG components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Report the global service without either modifier when billing both components together.
What documentation supports reporting 95816?
The record should support that an EEG was performed and identify the states captured; the interpreting physician’s report should document the findings and interpretation.
Is this code selected by recording minutes?
95816 identifies an awake-and-drowsy study, not a stated minute range. Codes 95812 and 95813 describe EEG recordings by longer duration ranges.
Can the technical and professional portions be billed separately?
Yes. Report the interpretation with modifier 26 and the technical portion with modifier TC when those portions are furnished and billed 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.
12,55395813,,Eeg extnd mntr 61-119 min,A,,1.63,12.61,,12.61,NA,0.12,14.36,14.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,55495813,26,Eeg extnd mntr 61-119 min,A,,1.63,0.94,,0.94,,0.07,2.64,2.64,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,55595813,TC,Eeg extnd mntr 61-119 min,A,,0.00,11.67,,11.67,NA,0.05,11.72,11.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,55695816,,Eeg awake and drowsy,A,,1.05,11.23,,11.23,NA,0.10,12.38,12.38,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,55795816,26,Eeg awake and drowsy,A,,1.05,0.59,,0.59,,0.05,1.69,1.69,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,55895816,TC,Eeg awake and drowsy,A,,0.00,10.64,,10.64,NA,0.05,10.69,10.69,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,55995819,,Eeg awake and asleep,A,,1.05,13.28,,13.28,NA,0.11,14.44,14.44,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097