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CPT code 95800: Home sleep study, unattended, includes sleep time2026 Medicare rate & RVUs in Virginia

Reports an unattended sleep study that records heart rate, oxygen saturation, respiratory data, and sleep time, commonly for evaluation of suspected sleep apnea.

CMS RVU26DEffective Oct 1, 2026One payment locality176.7K Medicare services in 2024

In Virginia, Medicare pays $138.80 for 95800 in the office.

$138.80Office (non-facility)
Not available in this settingHospital or facility
−1.8%vs the national office rate ($141.29)

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.

We’ll open 95800 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 95800 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Virginia 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. Virginia pays $138.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

95800 in Virginia vs other payment areas
  1. Virginia · this page$138.80
  2. Los Angeles, CA · California$162.16+$23.36
  3. Washington, DC area · District of Columbia$162.87+$24.07
  4. Miami, FL · Florida$148.92+$10.12
  5. Chicago, IL · Illinois$144.63+$5.83
  6. Manhattan, NY · New York$162.31+$23.51
  7. Alaska · Alaska$161.50+$22.70

Other areas in Virginia first, then benchmark localities. Bars start at $0.

Every other payment area

95800 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$126.47—
ArkansasArkansas$124.58—
ArizonaArizona$137.54—
Bakersfield, CACalifornia$151.74—
Chico, CACalifornia$151.54—
El Centro, CACalifornia$151.55—
Fresno, CACalifornia$151.54—
Hanford, CACalifornia$151.54—

95800 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
95800 office rate range by state
State / territoryOffice rate rangeLocalities
AK$161.501
AL$126.471
AR$124.581
AZ$137.541
CA$151.54–$192.7129
CO$148.321
CT$150.851
DC$162.871
DE$139.881
FL$137.39–$148.923
GA$129.62–$143.562
GU$155.731
HI$155.731
IA$130.591
ID$131.301
IL$132.71–$146.044
IN$132.111
KS$129.581
KY$128.731
LA$128.37–$134.982
MA$147.24–$163.842
MD$142.74–$162.873
ME$131.60–$139.542
MI$131.84–$138.762
MN$143.111
MO$125.84–$135.933
MS$125.261
MT$141.281
NC$133.091
ND$140.101
NE$131.451
NH$145.611
NJ$152.85–$161.022
NM$132.431
NV$141.061
NY$135.11–$165.865
OH$131.601
OK$128.901
OR$140.24–$153.602
PA$132.03–$146.752
PR$142.481
RI$145.281
SC$132.511
SD$139.961
TN$130.211
TX$131.10–$147.588
UT$134.391
VA$138.80–$162.872
VI$142.481
VT$139.181
WA$147.08–$167.632
WI$135.211
WV$127.541
WY$140.761

See 95800 in every payment locality

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

Office or facility?

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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 95800 in Virginia
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0000.8300
Practice expense3.34× 0.9833.2832
Malpractice0.06× 0.7060.0424
Total RVUs4.1556
Conversion factor× 33.4009

Office rate, Virginia$138.80

Office: (0.83 × 1 + 3.34 × 0.983 + 0.06 × 0.706) × $33.4009 = $138.80

Open 95800 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

Codes related to 95800

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 95800
CodeHow it relatesOffice range, Virginia
Same family
95801Sleep study, unattended, limited channelsUnattended study with heart rate, oxygen saturation, and respiratory analysis, without sleep-time measurement.$102.03
95806Sleep study, heart rate and respiratory signalsUnattended sleep study with a different specified respiratory-data configuration.$101.42
Used instead
95807Sleep study, technologist-attended recordingUse for an attended sleep study rather than an unattended recording.$435.16
95810Sleep study, age six or older, attendedUse for an attended polysomnography study with broader in-laboratory monitoring.$661.22
95811Sleep study, PAP titration, age 6+Use for attended polysomnography when positive airway pressure titration is performed.$694.58

How 95800 has changed in Virginia

95800 · Office / nonfacility

$138.80

Effective 2026-10-01

The base rate is $16.13 higher than on 2025-10-01, moving from $122.67 to $138.80 (13.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $122.67changed to$138.80

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $133.77changed to$122.67

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.18 changed to 2.95

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $131.58changed to$133.77

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $149.24changed to$131.58

    • 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 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $163.19changed to$149.24

    • 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
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $169.40changed to$163.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.98 changed to 3.84

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $167.53changed to$169.40

    • 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
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $170.50changed to$167.53

    • 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
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $178.55changed to$170.50

    • 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.

  10. January 1, 2018

    RVU18AR1

    $178.47changed to$178.55

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.93 changed to 3.91
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $177.74changed to$178.47

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.94 changed to 3.93
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $179.44changed to$177.74

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.97 changed to 3.94

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $178.55changed to$179.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $176.27changed to$178.55

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.91 changed to 3.97
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $178.57changed to$176.27

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.26 changed to 3.91
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $178.57

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$138.80Not available in this settingRVU26D
2026-07-01$138.80Not available in this settingRVU26C
2026-04-01$138.80Not available in this settingRVU26B
2026-01-01$138.80Not available in this settingRVU26A
2025-10-01$122.67Not available in this settingRVU25D
2025-07-01$122.67Not available in this settingRVU25C
2025-04-01$122.67Not available in this settingRVU25B
2025-01-01$122.67Not available in this settingRVU25A
2024-10-01$133.77Not available in this settingRVU24D
2024-07-01$133.77Not available in this settingRVU24C
2024-04-01$133.77Not available in this settingRVU24B
2024-03-09$133.77Not available in this settingRVU24AR
2024-01-01$131.58Not available in this settingRVU24A
2023-10-01$149.24Not available in this settingRVU23D
2023-07-01$149.24Not available in this settingRVU23C
2023-04-01$149.24Not available in this settingRVU23B
2023-01-01$149.24Not available in this settingRVU23A
2022-10-01$163.19Not available in this settingRVU22D
2022-07-01$163.19Not available in this settingRVU22C
2022-04-01$163.19Not available in this settingRVU22B
2022-01-01$163.19Not available in this settingRVU22A
2021-10-01$169.40Not available in this settingRVU21D
2021-07-01$169.40Not available in this settingRVU21C
2021-04-01$169.40Not available in this settingRVU21B
2021-01-01$169.40Not available in this settingRVU21A
2020-10-01$167.53Not available in this settingRVU20D
2020-07-01$167.53Not available in this settingRVU20C
2020-04-01$167.53Not available in this settingRVU20B
2020-01-01$167.53Not available in this settingRVU20A
2019-10-01$170.50Not available in this settingRVU19D
2019-07-01$170.50Not available in this settingRVU19C
2019-04-01$170.50Not available in this settingRVU19B
2019-01-01$170.50Not available in this settingRVU19A
2018-10-01$178.55Not available in this settingRVU18D
2018-07-01$178.55Not available in this settingRVU18C
2018-04-01$178.55Not available in this settingRVU18B
2018-01-01$178.55Not available in this settingRVU18AR1
2017-10-01$178.47Not available in this settingRVU17D
2017-07-01$178.47Not available in this settingRVU17C
2017-04-01$178.47Not available in this settingRVU17B
2017-01-01$178.47Not available in this settingRVU17A
2016-10-01$177.74Not available in this settingRVU16D
2016-07-01$177.74Not available in this settingRVU16C
2016-04-01$177.74Not available in this settingRVU16B
2016-01-01$177.74Not available in this settingRVU16A
2015-10-01$179.44Not available in this settingRVU15D
2015-07-01$179.44Not available in this settingRVU15C
2015-04-01$178.55Not available in this settingRVU15B
2015-01-01$178.55Not available in this settingRVU15A
2014-10-01$176.27Not available in this settingRVU14D
2014-07-01$176.27Not available in this settingRVU14C
2014-04-01$176.27Not available in this settingRVU14B
2014-01-01$176.27Not available in this settingRVU14A
2013-10-01$178.57Not available in this settingRVU13D
2013-07-01$178.57Not available in this settingRVU13C
2013-04-01$178.57Not available in this settingRVU13B
2013-01-01$178.57Not available in this settingRVU13AR

Price 95800 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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
RVUs for 95800PPRRVU2026_Oct_nonQPP.csv, line 12,523 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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