CPT 95822: Electroencephalogram for Coma or Sleep
Medicare pays $312 and commercial payers pay $458 on average nationally for this procedure.
CPT code 95822 describes an electroencephalogram (EEG) performed when the patient is in a state of coma or sleep, used to record scalp electrical brain activity for diagnostic evaluation; service type: diagnostic EEG for coma/sleep states; typical site of service: hospital inpatient or dedicated EEG laboratory/monitoring unit.
For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.
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National Reimbursement Benchmarks
National means place Blue Cross Blue Shield and BUCA noticeably above Medicare: Blue Cross Blue Shield’s mean of $534.40 and BUCA’s mean of $458.40 compare to Medicare’s mean of $311.50, indicating average commercial reimbursements for CPT 95822 are substantially higher than the Medicare average. This gap highlights a commercial-to-Medicare spread of $142.90 between BUCA and Medicare, and $222.90 between Blue Cross Blue Shield and Medicare.
Dispersion (P75 minus P25) varies by payer: Blue Cross Blue Shield’s spread is $243.00 (from $371.60 to $615.60) and BUCA’s spread is $288.70 (from $262.00 to $570.70), while UnitedHealth Group’s spread is $419.40 (from $136.80 to $557.20), Cigna’s is $449.70 (from $124.70 to $574.40), and Aetna’s is $300.00 (from $85.60 to $399.00). Medicare’s interquartile span is $388.50 (from $60.00 to $448.50). Cigna and UnitedHealth Group show the widest IQRs, indicating the greatest mid-distribution variability, while Blue Cross Blue Shield is among the tightest.