Billing code 95981: Gastric stimulator analysisMedicare rate & RVUs in Washington
Reports a subsequent intraoperative analysis of an implanted gastric neurostimulator when the device is checked without changing its programming.
Medicare pays $45.10–$51.15 for 95981 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 95981 covers
This service is an additional intraoperative check and analysis of an implanted gastric neurostimulator during an operation. It may arise when a surgeon or another clinician with device expertise evaluates the system while operating on a patient with a gastric neurostimulator, commonly used for gastroparesis. The service concerns analysis of the implanted device, not placement or revision of its electrodes.
Select this code for a subsequent intraoperative analysis when no reprogramming is performed. Use the initial code for the first analysis in the operative sequence; the sibling code for a subsequent analysis applies when reprogramming is performed. Documentation should identify the implanted gastric neurostimulator, the operative context, the sequence of the analysis, the findings, and whether settings were changed. CMS fee-schedule valuation includes work, practice expense, and malpractice components, with practice-expense values varying by setting.
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 95981 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $45.10 | $16.61 |
| Seattle (King Cnty) | $51.15 | $17.96 |
How the 95981 rate is calculated
Each of 95981’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 · 95981
RVUs × geographic indexes × conversion factor
Work0.29
0.29 RVUs× 1.000 GPCI
Practice expense0.96
0.96 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
1.3100
Conversion factor
$33.4009
Medicare rate
$43.76
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95981
95981 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 · 95981
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$43.76
- Non-facility (office)
- $43.76
- Facility
- $16.70
Higher because the practice carries its own overhead.
95981 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95980Neurostimulator analysis
- Use 95980 for the initial intraoperative gastric neurostimulator analysis; 95981 identifies a subsequent analysis without reprogramming.
- 95982Gastric stimulator
- Both describe subsequent intraoperative gastric neurostimulator analysis, but 95982 is selected when the service includes reprogramming.
- 95970Neurostimulator analysis
- 95970 describes electronic analysis of certain implanted neurostimulator systems without reprogramming. This code is specific to subsequent intraoperative analysis of a gastric neurostimulator.
95981 billing questions
How does this differ from 95980?
95980 is for the initial intraoperative analysis. Use 95981 for a subsequent analysis without reprogramming.
When is 95982 used instead?
95982 describes a subsequent intraoperative gastric neurostimulator analysis with reprogramming. The documented service, rather than the device alone, determines which code fits.
Does this code include implantation or revision of the stimulator?
No. It represents intraoperative device analysis; it does not describe placement or revision of gastric neurostimulator electrodes.
What should the operative documentation establish?
Document the gastric neurostimulator analysis, that it occurred intraoperatively, whether it was initial or subsequent, and whether reprogramming occurred.
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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