CPT 95961
Global XXX ActiveElectrode stimulation brain
CPT 95961 Billing & Documentation Guide
CPT code 95961 (Electrode stimulation brain) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.97, a non-facility practice expense RVU of 7.59, and a malpractice RVU of 0.37, a total non-facility RVU of 10.93 and facility RVU of 10.93. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $376.38, though rates vary from $323.33 to $482.3 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95961, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 95961 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95961 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 95961
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.97 | 2.97 |
| Practice Expense RVU | 7.59 | 7.59 |
| Malpractice RVU | 0.37 | 0.37 |
| Total RVU | 10.93 | 10.93 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95961
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $409.43 | $409.43 | $385.36 - $482.3 | 29 |
| Florida | $377.61 | $377.61 | $360.13 - $394.36 | 3 |
| Georgia | $355.99 | $355.99 | $340.07 - $371.91 | 2 |
| Illinois | $368.12 | $368.12 | $349.97 - $383.04 | 4 |
| Michigan | $354.65 | $354.65 | $344.61 - $364.68 | 2 |
| North Carolina | $343.63 | $343.63 | $343.63 - $343.63 | 1 |
| New York | $403.52 | $403.52 | $348.73 - $429.93 | 5 |
| Ohio | $343.12 | $343.12 | $343.12 - $343.12 | 1 |
| Pennsylvania | $361.62 | $361.62 | $343.6 - $379.64 | 2 |
| Texas | $360.81 | $360.81 | $341.38 - $378.57 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 95961
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95961 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0858T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95920 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 95938 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 95939 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 95940 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 95957 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99201 | Column 1 (primary), can be billed with modifier | 9 | HCPCS/CPT procedure code definition |
Frequently Asked Questions, CPT 95961
What does CPT code 95961 mean? +
CPT code 95961 represents: Electrode stimulation brain. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95961? +
The 2026 Medicare national average non-facility payment for CPT 95961 is $376.38. Rates range from $323.33 to $482.3 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95961? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 95961? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 17, 2026.
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