CPT 95970: Electronic Analysis of Implanted Neurostimulator
Medicare pays $20 and commercial payers pay $127 on average nationally for this procedure.
CPT code 95970 describes an electronic analysis service for a previously implanted neurostimulator pulse generator/transmitter performed by a physician or other qualified healthcare professional to verify device function; the service is diagnostic in nature and does not include reprogramming. This device interrogation/analysis service is typically provided in an outpatient clinic or hospital setting and is classified as a non-procedural, diagnostic device evaluation of implanted neurostimulation hardware.
For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.
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National Reimbursement Benchmarks
Commercial averages are meaningfully higher than Medicare for CPT 95970: Blue Cross Blue Shield and BUCA show substantially elevated means versus Medicare’s mean of $20.2. BUCA’s mean of $127.4 sits well above Medicare, and Blue Cross Blue Shield’s mean of $195.5 is highest among listed commercial payers, highlighting a clear commercial–Medicare gap in national mean rates.
Dispersion (P75 minus P25) varies across payers: Blue Cross Blue Shield displays the widest interquartile spread at $71.0 ($235.4 − $164.5), indicating greater variability in negotiated commercial rates. Aetna and UnitedHealth Group show moderate spreads of $25.0 ($42.0 − $18.4) and $27.0 ($50.3 − $22.8), respectively. Cigna’s spread is $28.8 ($51.2 − $23.2). BUCA’s interquartile spread is $51.8 ($155.0 − $103.2), and Medicare’s spread is narrow at $2.0 ($21 − $19), making Medicare the tightest payer by this measure.