Eeg monitoring/function test
EEG monitoring with functional testing costs range from $768 to $1,017 depending on whether you receive care at a Medicare facility or hospital outpatient center, making it essential to verify your billing location before treatment.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
Code 95958 covers EEG brain wave monitoring while the patient performs specific tasks like speaking, reading, or moving to test brain function during activities. This procedure is typically ordered for patients with seizures, memory problems, or other neurological symptoms that may only appear during certain functions. Billing requires careful documentation of the functional testing performed, as this code charges approximately 8-12 times the basic EEG monitoring rate.
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Facility rate
$768
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
3
23 data points
Key insights for CPT 95958
Facility vs office setting
$669 differenceNon-facility setting is less expensive for this procedure
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Facility (physician office) | $768 | +676% |
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $1,017 | +928% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Related procedures
Related pricing data
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use