Cost analysis for CPT 95816 — Measurement of brain wave activity (eeg), awake and drowsy
Average Medicare Payment
$126.05
2023 data
Total Payments (2023)
$44.2M
Services (2023)
260.9K
Price Change (2014–2023)
+16.5%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $108.24 | $26.0M | 273.6K | — |
| 2015 | $110.73 | $27.5M | 277.2K | +2.3% |
| 2016 | $111.18 | $28.2M | 277.5K | +0.4% |
| 2017 | $112.11 | $28.6M | 277.7K | +0.8% |
| 2018 | $113.79 | $30.0M | 276.4K | +1.5% |
| 2019 | $116.76 | $31.6M | 272.3K | +2.6% |
| 2020 | $117.82 | $25.3M | 214.8K | +0.9% |
| 2021 | $125.69 | $29.0M | 222.4K | +6.7% |
| 2022 | $126.30 | $31.2M | 221.1K | +0.5% |
| 2023 | $126.05 | $44.2M | 260.9K | -0.2% |
The most expensive state pays 6.9x more than the cheapest for this procedure. CA averages $275.66 vs ID at $40.20.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| CA | $275.66 | $17.8M | 64.4K | 363 |
| PR | $256.74 | $46.7K | 182 | 8 |
| NY | $221.58 | $5.6M | 25.1K | 321 |
| WY | $221.32 | $35.4K | 160 | 4 |
| AZ | $187.42 | $1.2M | 6.4K | 96 |
| VA | $165.72 | $906.0K | 5.5K | 89 |
| MO | $164.78 | $1.4M | 8.4K | 89 |
| NJ | $164.26 | $1.6M | 9.5K | 133 |
| TX | $163.24 | $2.7M | 16.6K | 329 |
| NM | $151.49 | $51.7K | 341 | 8 |
| DC | $146.77 | $133.4K | 909 | 13 |
| MI | $145.09 | $861.1K | 5.9K | 129 |
| RI | $144.95 | $175.4K | 1.2K | 18 |
| AR | $143.71 | $291.6K | 2.0K | 39 |
| FL | $141.47 | $2.8M | 19.5K | 351 |
| NV | $141.33 | $942.4K | 6.7K | 66 |
| WV | $141.18 | $180.1K | 1.3K | 12 |
| NC | $139.37 | $677.8K | 4.9K | 99 |
| HI | $136.80 | $50.5K | 369 | 9 |
| LA | $116.11 | $342.8K | 3.0K | 54 |
| OK | $109.19 | $206.2K | 1.9K | 34 |
| SC | $108.23 | $473.6K | 4.4K | 68 |
| AK | $106.71 | $10.9K | 102 | 5 |
| MS | $105.57 | $202.3K | 1.9K | 34 |
| GA | $105.04 | $530.4K | 5.0K | 119 |
| AL | $104.21 | $279.6K | 2.7K | 56 |
| OH | $103.57 | $926.0K | 8.9K | 153 |
| UT | $102.39 | $53.9K | 526 | 11 |
| MD | $96.70 | $498.5K | 5.2K | 80 |
| IN | $96.47 | $500.9K | 5.2K | 100 |
| TN | $95.45 | $424.3K | 4.4K | 84 |
| MA | $81.30 | $398.7K | 4.9K | 87 |
| MN | $81.14 | $118.2K | 1.5K | 43 |
| OR | $75.16 | $50.5K | 672 | 27 |
| ND | $73.94 | $33.1K | 447 | 12 |
| CO | $73.15 | $96.8K | 1.3K | 38 |
| ME | $72.82 | $22.2K | 305 | 11 |
| IL | $70.56 | $450.0K | 6.4K | 136 |
| WI | $64.96 | $104.3K | 1.6K | 59 |
| CT | $61.72 | $139.8K | 2.3K | 34 |
| NE | $61.35 | $37.4K | 609 | 19 |
| WA | $60.04 | $115.5K | 1.9K | 50 |
| DE | $58.77 | $49.3K | 838 | 16 |
| PA | $58.42 | $508.5K | 8.7K | 168 |
| VT | $57.62 | $15.0K | 261 | 9 |
| NH | $55.22 | $52.2K | 946 | 23 |
| KY | $52.26 | $151.2K | 2.9K | 58 |
| KS | $49.57 | $46.4K | 937 | 22 |
| IA | $45.10 | $31.6K | 700 | 17 |
| SD | $41.60 | $25.0K | 602 | 12 |
| MT | $40.99 | $5.5K | 135 | 6 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Seth Camhi | Family Practice | CA | $2.9M | 8.1K | $351.88 |
| Luis Navazo | Family Practice | CA | $972.8K | 2.8K | $351.97 |
| Maruska Sanchez | Nurse Practitioner | CA | $694.8K | 2.0K | $340.59 |
| Richard Musselman | Family Practice | CA | $678.5K | 1.9K | $352.11 |
| My Van Nguyen | Nurse Practitioner | CA | $591.7K | 2.0K | $298.98 |
| Theresa Timony | Nurse Practitioner | CA | $567.0K | 1.9K | $298.73 |
| Jason Duryee | Nurse Practitioner | CA | $559.3K | 1.9K | $299.25 |
| Thai Nguyen | Nurse Practitioner | CA | $519.8K | 1.9K | $277.07 |
| Oscar Castillo | Nurse Practitioner | CA | $511.4K | 1.8K | $276.72 |
| Christina Quach | Nurse Practitioner | CA | $443.3K | 1.5K | $301.60 |
| Gail Perry | Nurse Practitioner | VA | $439.9K | 1.5K | $301.89 |
| Maria Sanchez | Nurse Practitioner | CA | $414.8K | 1.2K | $354.56 |
| Cindy Defilippi | Nurse Practitioner | CA | $389.2K | 1.3K | $298.49 |
| Ralaine Abdon | Nurse Practitioner | CA | $385.8K | 1.4K | $284.28 |
| Lauren Lowery | Nurse Practitioner | CA | $385.7K | 1.3K | $299.25 |
| Marissa Lewis | Emergency Medicine | MO | $375.2K | 1.3K | $294.01 |
| Katherine Barringer | Nurse Practitioner | CA | $371.8K | 1.2K | $300.31 |
| Katherine Henson | Nurse Practitioner | CA | $357.0K | 1.3K | $276.33 |
| Michelle Erazo | Nurse Practitioner | CA | $352.5K | 1.0K | $338.32 |
| Amit Khaneja | Neurology | NY | $329.4K | 931 | $353.85 |
The data suggests significant pricing inconsistencies for CPT 95816. With a 6.9x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have risen 16.5% since 2014, outpacing inflation and raising questions about whether reimbursement rates reflect actual costs.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.