CPT code 95800: Home sleep study, unattended, includes sleep time2026 Medicare rate & RVUs in Madera, CA
Reports an unattended sleep study that records heart rate, oxygen saturation, respiratory data, and sleep time, commonly for evaluation of suspected sleep apnea.
In Madera, CA, Medicare pays $151.54 for 95800 in the office.
Check a contract rate as a % of Medicare · 95800 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 95800 covers
This code describes an unattended sleep study using portable equipment to record heart rate, oxygen saturation, respiratory information, and sleep time during a sleep period. It is commonly used when evaluating a patient for suspected obstructive sleep apnea outside a sleep laboratory. A sleep medicine physician or other qualified interpreting professional reviews the recorded data and prepares the interpretation; equipment and staff support the technical portion of the test.
Select this code when the study includes sleep-time measurement along with the specified physiologic data. The report should identify the study performed and document the recorded data and the interpreting professional’s findings. CMS recognizes professional and technical components: report modifier 26 for interpretation or modifier TC for equipment and staff; without a component modifier, the claim represents the global service. CMS separately prices these modifier components.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Madera, CA compares for 95800
Across 109 of 109 payment localities, the office rate for 95800 runs from $124.58 in Arkansas to $192.71 in San Benito County, CA. Madera, CA pays $151.54. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Madera, CA · this page$151.54
- Bakersfield, CA · California$151.74+$0.20
- Chico, CA · California$151.54
- El Centro, CA · California$151.55+$0.01
- Fresno, CA · California$151.54
- Hanford, CA · California$151.54
- Los Angeles, CA · California$162.16+$10.62
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Merced, CACalifornia | $151.54 | — |
| Modesto, CACalifornia | $151.54 | — |
| Napa, CACalifornia | $177.52 | — |
| Oxnard, CACalifornia | $161.61 | — |
| Redding, CACalifornia | $151.54 | — |
| Rest of CaliforniaCalifornia | $151.54 | — |
| Riverside, CACalifornia | $152.20 | — |
| Sacramento, CACalifornia | $159.54 | — |
| Salinas, CACalifornia | $158.95 | — |
| San Diego, CACalifornia | $163.07 | — |
| Marin County, CACalifornia | $188.57 | — |
| San Francisco, CACalifornia | $188.51 | — |
| San Benito County, CACalifornia | $192.71 | — |
| Santa Clara County, CACalifornia | $192.44 | — |
| San Luis Obispo, CACalifornia | $156.33 | — |
| Santa Cruz, CACalifornia | $164.92 | — |
| Santa Maria, CACalifornia | $159.65 | — |
| Santa Rosa, CACalifornia | $166.62 | — |
| Stockton, CACalifornia | $151.54 | — |
| Vallejo, CACalifornia | $177.42 | — |
| Visalia, CACalifornia | $151.54 | — |
| Yuba City, CACalifornia | $151.54 | — |
| Washington, DC areaDistrict of Columbia | $162.87 | — |
| Miami, FLFlorida | $148.92 | — |
| Chicago, ILIllinois | $144.63 | — |
| Manhattan, NYNew York | $162.31 | — |
| AlaskaAlaska | $161.50 | — |
| AlabamaAlabama | $126.47 | — |
| ArkansasArkansas | $124.58 | — |
| ArizonaArizona | $137.54 | — |
| ColoradoColorado | $148.32 | — |
| ConnecticutConnecticut | $150.85 | — |
| DelawareDelaware | $139.88 | — |
| Fort Lauderdale, FLFlorida | $144.36 | — |
| Rest of FloridaFlorida | $137.39 | — |
| Atlanta, GAGeorgia | $143.56 | — |
| Rest of GeorgiaGeorgia | $129.62 | — |
| Hawaii, Guam, HIHawaii | $155.73 | — |
| IowaIowa | $130.59 | — |
| IdahoIdaho | $131.30 | — |
| East St. Louis, ILIllinois | $134.39 | — |
| Rest of IllinoisIllinois | $132.71 | — |
| Suburban Chicago, ILIllinois | $146.04 | — |
| IndianaIndiana | $132.11 | — |
| KansasKansas | $129.58 | — |
| KentuckyKentucky | $128.73 | — |
| New Orleans, LALouisiana | $134.98 | — |
| Rest of LouisianaLouisiana | $128.37 | — |
| Metropolitan Boston, MAMassachusetts | $163.84 | — |
| Rest of MassachusettsMassachusetts | $147.24 | — |
| Baltimore area, MDMaryland | $150.35 | — |
| Rest of MarylandMaryland | $142.74 | — |
| Rest of MaineMaine | $131.60 | — |
| Southern Maine, MEMaine | $139.54 | — |
| Detroit, MIMichigan | $138.76 | — |
| Rest of MichiganMichigan | $131.84 | — |
| MinnesotaMinnesota | $143.11 | — |
| Metropolitan Kansas City, MOMissouri | $134.43 | — |
| Metropolitan St. Louis, MOMissouri | $135.93 | — |
| Rest of MissouriMissouri | $125.84 | — |
| MississippiMississippi | $125.26 | — |
| MontanaMontana | $141.28 | — |
| North CarolinaNorth Carolina | $133.09 | — |
| North DakotaNorth Dakota | $140.10 | — |
| NebraskaNebraska | $131.45 | — |
| New HampshireNew Hampshire | $145.61 | — |
| Northern New JerseyNew Jersey | $161.02 | — |
| Rest of New JerseyNew Jersey | $152.85 | — |
| New MexicoNew Mexico | $132.43 | — |
| NevadaNevada | $141.06 | — |
| NYC suburbs and Long Island, NYNew York | $165.86 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $153.55 | — |
| Queens, NYNew York | $164.25 | — |
| Rest of New YorkNew York | $135.11 | — |
| OhioOhio | $131.60 | — |
| OklahomaOklahoma | $128.90 | — |
| Portland, OROregon | $153.60 | — |
| Rest of OregonOregon | $140.24 | — |
| Metropolitan Philadelphia, PAPennsylvania | $146.75 | — |
| Rest of PennsylvaniaPennsylvania | $132.03 | — |
| Puerto RicoPuerto Rico | $142.48 | — |
| Rhode IslandRhode Island | $145.28 | — |
| South CarolinaSouth Carolina | $132.51 | — |
| South DakotaSouth Dakota | $139.96 | — |
| TennesseeTennessee | $130.21 | — |
| Austin, TXTexas | $147.58 | — |
| Beaumont, TXTexas | $131.10 | — |
| Brazoria, TXTexas | $140.06 | — |
| Dallas, TXTexas | $140.80 | — |
| Fort Worth, TXTexas | $139.71 | — |
| Galveston, TXTexas | $140.38 | — |
| Houston, TXTexas | $141.48 | — |
| Rest of TexasTexas | $135.40 | — |
| UtahUtah | $134.39 | — |
| VirginiaVirginia | $138.80 | — |
| Virgin Islands, VIUnited States Virgin Islands | $142.48 | — |
| VermontVermont | $139.18 | — |
| Rest of WashingtonWashington | $147.08 | — |
| King County, WAWashington | $167.63 | — |
| WisconsinWisconsin | $135.21 | — |
| West VirginiaWest Virginia | $127.54 | — |
| WyomingWyoming | $140.76 | — |
95800 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$124.58
$172.13
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $161.50 | 1 |
| AL | $126.47 | 1 |
| AR | $124.58 | 1 |
| AZ | $137.54 | 1 |
| CA | $151.54–$192.71 | 29 |
| CO | $148.32 | 1 |
| CT | $150.85 | 1 |
| DC | $162.87 | 1 |
| DE | $139.88 | 1 |
| FL | $137.39–$148.92 | 3 |
| GA | $129.62–$143.56 | 2 |
| GU | $155.73 | 1 |
| HI | $155.73 | 1 |
| IA | $130.59 | 1 |
| ID | $131.30 | 1 |
| IL | $132.71–$146.04 | 4 |
| IN | $132.11 | 1 |
| KS | $129.58 | 1 |
| KY | $128.73 | 1 |
| LA | $128.37–$134.98 | 2 |
| MA | $147.24–$163.84 | 2 |
| MD | $142.74–$162.87 | 3 |
| ME | $131.60–$139.54 | 2 |
| MI | $131.84–$138.76 | 2 |
| MN | $143.11 | 1 |
| MO | $125.84–$135.93 | 3 |
| MS | $125.26 | 1 |
| MT | $141.28 | 1 |
| NC | $133.09 | 1 |
| ND | $140.10 | 1 |
| NE | $131.45 | 1 |
| NH | $145.61 | 1 |
| NJ | $152.85–$161.02 | 2 |
| NM | $132.43 | 1 |
| NV | $141.06 | 1 |
| NY | $135.11–$165.86 | 5 |
| OH | $131.60 | 1 |
| OK | $128.90 | 1 |
| OR | $140.24–$153.60 | 2 |
| PA | $132.03–$146.75 | 2 |
| PR | $142.48 | 1 |
| RI | $145.28 | 1 |
| SC | $132.51 | 1 |
| SD | $139.96 | 1 |
| TN | $130.21 | 1 |
| TX | $131.10–$147.58 | 8 |
| UT | $134.39 | 1 |
| VA | $138.80–$162.87 | 2 |
| VI | $142.48 | 1 |
| VT | $139.18 | 1 |
| WA | $147.08–$167.63 | 2 |
| WI | $135.21 | 1 |
| WV | $127.54 | 1 |
| WY | $140.76 | 1 |
How the 95800 rate is calculated
Each of 95800’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 95800
RVUs × geographic indexes × conversion factor
Work0.83
0.83 RVUs× 1.000 GPCI
Practice expense3.34
3.34 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
4.2300
Conversion factor
$33.4009
Medicare rate
$141.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Madera, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,523
- Code
- 95800
- Physician work
- 0.83
- Practice expense
- 3.34
- Malpractice
- 0.06
GPCI2026.csv
14
- Locality
- Madera, CA
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.017 | 0.8441 |
| Practice expense | 3.34 | × 1.096 | 3.6606 |
| Malpractice | 0.06 | × 0.536 | 0.0322 |
| Total RVUs | 4.5369 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Madera, CA$151.54
Office: (0.83 × 1.017 + 3.34 × 1.096 + 0.06 × 0.536) × $33.4009 = $151.54
Payment rules and modifiers for 95800
The CMS indicators that decide how 95800 is paid alongside other services.
CMS payment indicators · 95800
Home sleep study, unattended, includes sleep time
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95800 without 26 · national office
$141.29
Home sleep study, unattended, includes sleep time
95800-26 · Professional component
$38.75
Pays only the interpretation and report.
How 95800 has changed in Madera, CA
95800 · Office / nonfacility
$151.54
Effective 2026-10-01
The base rate is $18.46 higher than on 2025-10-01, moving from $133.08 to $151.54 (13.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$133.08changed to$151.54
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.85 changed to 0.83
- Practice expense RVU 2.95 changed to 3.34
- Malpractice RVU 0.05 changed to 0.06
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$145.32changed to$133.08
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.18 changed to 2.95
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$142.95changed to$145.32
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$160.02changed to$142.95
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.54 changed to 3.18
- Malpractice RVU 0.06 changed to 0.05
- Work GPCI 1.021 changed to 1.014
- Practice expense GPCI 1.079 changed to 1.093
- Malpractice GPCI 0.579 changed to 0.560
January 1, 2023
RVU23A
$172.77changed to$160.02
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.84 changed to 3.54
- Malpractice RVU 0.05 changed to 0.06
- Work GPCI 1.027 changed to 1.021
- Practice expense GPCI 1.065 changed to 1.079
- Malpractice GPCI 0.597 changed to 0.579
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$179.40changed to$172.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.98 changed to 3.84
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$178.60changed to$179.40
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.79 changed to 3.98
- Malpractice RVU 0.04 changed to 0.05
- Work GPCI 1.024 changed to 1.027
- Practice expense GPCI 1.070 changed to 1.065
- Malpractice GPCI 0.580 changed to 0.597
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$182.82changed to$178.60
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.89 changed to 3.79
- Malpractice RVU 0.05 changed to 0.04
- Work GPCI 1.020 changed to 1.024
- Practice expense GPCI 1.074 changed to 1.070
- Malpractice GPCI 0.562 changed to 0.580
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$190.94changed to$182.82
- Conversion factor 35.9996 changed to 36.0391
- Work RVU 1.05 changed to 0.85
- Practice expense RVU 3.91 changed to 3.89
- Malpractice RVU 0.06 changed to 0.05
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$192.09changed to$190.94
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.93 changed to 3.91
- Work GPCI 1.024 changed to 1.020
- Practice expense GPCI 1.079 changed to 1.074
- Malpractice GPCI 0.610 changed to 0.562
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$192.09
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $151.54 | Not available in this setting | RVU26D |
| 2026-07-01 | $151.54 | Not available in this setting | RVU26C |
| 2026-04-01 | $151.54 | Not available in this setting | RVU26B |
| 2026-01-01 | $151.54 | Not available in this setting | RVU26A |
| 2025-10-01 | $133.08 | Not available in this setting | RVU25D |
| 2025-07-01 | $133.08 | Not available in this setting | RVU25C |
| 2025-04-01 | $133.08 | Not available in this setting | RVU25B |
| 2025-01-01 | $133.08 | Not available in this setting | RVU25A |
| 2024-10-01 | $145.32 | Not available in this setting | RVU24D |
| 2024-07-01 | $145.32 | Not available in this setting | RVU24C |
| 2024-04-01 | $145.32 | Not available in this setting | RVU24B |
| 2024-03-09 | $145.32 | Not available in this setting | RVU24AR |
| 2024-01-01 | $142.95 | Not available in this setting | RVU24A |
| 2023-10-01 | $160.02 | Not available in this setting | RVU23D |
| 2023-07-01 | $160.02 | Not available in this setting | RVU23C |
| 2023-04-01 | $160.02 | Not available in this setting | RVU23B |
| 2023-01-01 | $160.02 | Not available in this setting | RVU23A |
| 2022-10-01 | $172.77 | Not available in this setting | RVU22D |
| 2022-07-01 | $172.77 | Not available in this setting | RVU22C |
| 2022-04-01 | $172.77 | Not available in this setting | RVU22B |
| 2022-01-01 | $172.77 | Not available in this setting | RVU22A |
| 2021-10-01 | $179.40 | Not available in this setting | RVU21D |
| 2021-07-01 | $179.40 | Not available in this setting | RVU21C |
| 2021-04-01 | $179.40 | Not available in this setting | RVU21B |
| 2021-01-01 | $179.40 | Not available in this setting | RVU21A |
| 2020-10-01 | $178.60 | Not available in this setting | RVU20D |
| 2020-07-01 | $178.60 | Not available in this setting | RVU20C |
| 2020-04-01 | $178.60 | Not available in this setting | RVU20B |
| 2020-01-01 | $178.60 | Not available in this setting | RVU20A |
| 2019-10-01 | $182.82 | Not available in this setting | RVU19D |
| 2019-07-01 | $182.82 | Not available in this setting | RVU19C |
| 2019-04-01 | $182.82 | Not available in this setting | RVU19B |
| 2019-01-01 | $182.82 | Not available in this setting | RVU19A |
| 2018-10-01 | $190.94 | Not available in this setting | RVU18D |
| 2018-07-01 | $190.94 | Not available in this setting | RVU18C |
| 2018-04-01 | $190.94 | Not available in this setting | RVU18B |
| 2018-01-01 | $190.94 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $192.09 | Not available in this setting | RVU17D |
| 2017-07-01 | $192.09 | Not available in this setting | RVU17C |
| 2017-04-01 | $192.09 | Not available in this setting | RVU17B |
| 2017-01-01 | $192.09 | Not available in this setting | RVU17A |
| 2016-10-01 | Rate data unavailable | Not available in this setting | RVU16D |
| 2016-07-01 | Rate data unavailable | Not available in this setting | RVU16C |
| 2016-04-01 | Rate data unavailable | Not available in this setting | RVU16B |
| 2016-01-01 | Rate data unavailable | Not available in this setting | RVU16A |
| 2015-10-01 | Rate data unavailable | Not available in this setting | RVU15D |
| 2015-07-01 | Rate data unavailable | Not available in this setting | RVU15C |
| 2015-04-01 | Rate data unavailable | Not available in this setting | RVU15B |
| 2015-01-01 | Rate data unavailable | Not available in this setting | RVU15A |
| 2014-10-01 | Rate data unavailable | Not available in this setting | RVU14D |
| 2014-07-01 | Rate data unavailable | Not available in this setting | RVU14C |
| 2014-04-01 | Rate data unavailable | Not available in this setting | RVU14B |
| 2014-01-01 | Rate data unavailable | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Madera, CA rate applies
Madera, CA is a Medicare payment area, not a city. Our Census mapping connects it to 17 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Madera
- Ahwahnee
- Bass Lake
- Bonadelle Ranchos
- Chowchilla
- Coarsegold
- Fairmead
- La Vina
95800 billing questions
How does 95800 differ from 95801?
95800 includes sleep-time measurement in addition to heart rate, oxygen saturation, and respiratory analysis. Choose 95801 when the study does not include sleep-time measurement.
How does 95800 differ from 95806?
The codes describe different unattended study data configurations. 95800 includes sleep time, while 95806 identifies a study with respiratory effort and airflow.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the equipment and staff portion. Billing without either modifier represents the global service.
What documentation supports reporting 95800?
Document the unattended study performed, the data recorded—including sleep time—and the interpreting professional’s findings.
Is 95800 an attended laboratory study?
No. It describes an unattended study. Code 95807 describes an attended sleep study.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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