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CPT code 95803: Actigraphy testing, at least 72 hours2026 Medicare rate & RVUs in North Carolina

Reports actigraphy recording and analysis over at least 72 hours to assess sleep-wake patterns, such as in insomnia or circadian rhythm evaluation.

CMS RVU26DEffective Oct 1, 2026One payment locality131 Medicare services in 2024

In North Carolina, Medicare pays $127.69 for 95803 in the office.

$127.69Office (non-facility)
Not available in this settingHospital or facility
−5.6%vs the national office rate ($135.27)

Check a contract rate as a % of Medicare · 95803 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 95803 for the payment locality that covers the ZIP.

On this page 10 sections
  1. Rate in North Carolina
  2. What 95803 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Rate history
  8. Where it applies
  9. Billing questions
  10. Sources

What 95803 covers

Actigraphy uses a wearable motion-sensing device, commonly worn on the wrist, to record activity and rest over time and estimate sleep-wake patterns. A sleep medicine clinician may use the results when evaluating insomnia, a suspected circadian rhythm sleep-wake disorder, or a mismatch between reported sleep and observed routines. The test covers recording for at least 72 hours, followed by analysis, interpretation, and a report; it does not measure sleep stages or respiratory events like a sleep study.

Report 95803 for the actigraphy service, supported by documentation of the recording period, analysis, interpretation, and findings. The code has separately priced professional and technical components: modifier 26 identifies interpretation, while modifier TC identifies equipment and staff. Reporting the code without either modifier represents the global service. The record should identify the device-based recording period and explain how the results address the sleep-wake question being evaluated.

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 North Carolina compares for 95803

Across 109 of 109 payment localities, the office rate for 95803 runs from $119.77 in Arkansas to $183.79 in San Benito County, CA. North Carolina pays $127.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

95803 in North Carolina vs other payment areas
  1. North Carolina · this page$127.69
  2. Los Angeles, CA · California$154.99+$27.30
  3. Washington, DC area · District of Columbia$155.60+$27.91
  4. Miami, FL · Florida$142.10+$14.41
  5. Chicago, IL · Illinois$138.16+$10.47
  6. Manhattan, NY · New York$155.02+$27.33
  7. Alaska · Alaska$155.99+$28.30

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

Every other payment area

95803 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$121.52—
ArkansasArkansas$119.77—
ArizonaArizona$131.80—
Bakersfield, CACalifornia$145.18—
Chico, CACalifornia$145.00—
El Centro, CACalifornia$145.01—
Fresno, CACalifornia$145.00—
Hanford, CACalifornia$145.00—

95803 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.

$119.77

$164.39

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95803 office rate range by state
State / territoryOffice rate rangeLocalities
AK$155.991
AL$121.521
AR$119.771
AZ$131.801
CA$145.00–$183.7929
CO$141.931
CT$144.241
DC$155.601
DE$134.001
FL$131.53–$142.103
GA$124.34–$137.362
GU$148.851
HI$148.851
IA$125.411
ID$126.061
IL$127.15–$139.584
IN$126.811
KS$124.441
KY$123.561
LA$123.22–$129.352
MA$140.93–$156.512
MD$136.68–$155.603
ME$126.31–$133.722
MI$126.42–$132.772
MN$137.121
MO$120.85–$130.273
MS$120.351
MT$135.271
NC$127.691
ND$134.281
NE$126.211
NH$139.341
NJ$146.20–$153.912
NM$126.961
NV$135.101
NY$129.57–$158.285
OH$126.221
OK$123.751
OR$134.36–$146.882
PA$126.64–$140.402
PR$136.391
RI$139.091
SC$127.101
SD$134.161
TN$125.021
TX$125.78–$141.198
UT$128.851
VA$133.01–$155.602
VI$136.391
VT$133.411
WA$140.78–$160.092
WI$129.741
WV$122.341
WY$134.841

See 95803 in every payment locality

How the 95803 rate is calculated

Each of 95803’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 · 95803

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.88

0.88 RVUs× 1.000 GPCI

Practice expense3.12

3.12 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

4.0500

Conversion factor

$33.4009

Medicare rate

$135.27

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,529

Code
95803
Physician work
0.88
Practice expense
3.12
Malpractice
0.05

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 95803 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.88× 1.0000.8800
Practice expense3.12× 0.9332.9110
Malpractice0.05× 0.6390.0319
Total RVUs3.8229
Conversion factor× 33.4009

Office rate, North Carolina$127.69

Office: (0.88 × 1 + 3.12 × 0.933 + 0.05 × 0.639) × $33.4009 = $127.69

Open 95803 in the RVU calculator

Payment rules and modifiers for 95803

The CMS indicators that decide how 95803 is paid alongside other services.

CMS payment indicators · 95803

Actigraphy testing, at least 72 hours

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

95803 without 26 · national office

$135.27

Actigraphy testing, at least 72 hours

95803-26 · Professional component

$42.75

Pays only the interpretation and report.

When to use modifier 26

How 95803 has changed in North Carolina

95803 · Office / nonfacility

$127.69

Effective 2026-10-01

The base rate is $8.67 higher than on 2025-10-01, moving from $119.02 to $127.69 (7.3%).

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

    $119.02changed to$127.69

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.90 changed to 0.88
    • Practice expense RVU 2.98 changed to 3.12
    • Malpractice RVU 0.03 changed to 0.05
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $127.10changed to$119.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.13 changed to 2.98

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $125.03changed to$127.10

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $132.40changed to$125.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.22 changed to 3.13
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $141.19changed to$132.40

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.40 changed to 3.22
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $147.78changed to$141.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.55 changed to 3.40
    • Malpractice RVU 0.05 changed to 0.03

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $143.66changed to$147.78

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.28 changed to 3.55
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $138.04changed to$143.66

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.11 changed to 3.28
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $137.88changed to$138.04

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $134.85changed to$137.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.03 changed to 3.11
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $135.16changed to$134.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.05 changed to 3.03
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $135.37changed to$135.16

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.04 changed to 0.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $134.70changed to$135.37

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $142.38changed to$134.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.27 changed to 3.05
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $143.14changed to$142.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.53 changed to 3.27
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $143.14

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$127.69Not available in this settingRVU26D
2026-07-01$127.69Not available in this settingRVU26C
2026-04-01$127.69Not available in this settingRVU26B
2026-01-01$127.69Not available in this settingRVU26A
2025-10-01$119.02Not available in this settingRVU25D
2025-07-01$119.02Not available in this settingRVU25C
2025-04-01$119.02Not available in this settingRVU25B
2025-01-01$119.02Not available in this settingRVU25A
2024-10-01$127.10Not available in this settingRVU24D
2024-07-01$127.10Not available in this settingRVU24C
2024-04-01$127.10Not available in this settingRVU24B
2024-03-09$127.10Not available in this settingRVU24AR
2024-01-01$125.03Not available in this settingRVU24A
2023-10-01$132.40Not available in this settingRVU23D
2023-07-01$132.40Not available in this settingRVU23C
2023-04-01$132.40Not available in this settingRVU23B
2023-01-01$132.40Not available in this settingRVU23A
2022-10-01$141.19Not available in this settingRVU22D
2022-07-01$141.19Not available in this settingRVU22C
2022-04-01$141.19Not available in this settingRVU22B
2022-01-01$141.19Not available in this settingRVU22A
2021-10-01$147.78Not available in this settingRVU21D
2021-07-01$147.78Not available in this settingRVU21C
2021-04-01$147.78Not available in this settingRVU21B
2021-01-01$147.78Not available in this settingRVU21A
2020-10-01$143.66Not available in this settingRVU20D
2020-07-01$143.66Not available in this settingRVU20C
2020-04-01$143.66Not available in this settingRVU20B
2020-01-01$143.66Not available in this settingRVU20A
2019-10-01$138.04Not available in this settingRVU19D
2019-07-01$138.04Not available in this settingRVU19C
2019-04-01$138.04Not available in this settingRVU19B
2019-01-01$138.04Not available in this settingRVU19A
2018-10-01$137.88Not available in this settingRVU18D
2018-07-01$137.88Not available in this settingRVU18C
2018-04-01$137.88Not available in this settingRVU18B
2018-01-01$137.88Not available in this settingRVU18AR1
2017-10-01$134.85Not available in this settingRVU17D
2017-07-01$134.85Not available in this settingRVU17C
2017-04-01$134.85Not available in this settingRVU17B
2017-01-01$134.85Not available in this settingRVU17A
2016-10-01$135.16Not available in this settingRVU16D
2016-07-01$135.16Not available in this settingRVU16C
2016-04-01$135.16Not available in this settingRVU16B
2016-01-01$135.16Not available in this settingRVU16A
2015-10-01$135.37Not available in this settingRVU15D
2015-07-01$135.37Not available in this settingRVU15C
2015-04-01$134.70Not available in this settingRVU15B
2015-01-01$134.70Not available in this settingRVU15A
2014-10-01$142.38Not available in this settingRVU14D
2014-07-01$142.38Not available in this settingRVU14C
2014-04-01$142.38Not available in this settingRVU14B
2014-01-01$142.38Not available in this settingRVU14A
2013-10-01$143.14Not available in this settingRVU13D
2013-07-01$143.14Not available in this settingRVU13C
2013-04-01$143.14Not available in this settingRVU13B
2013-01-01$143.14Not available in this settingRVU13AR

Price 95803 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

95803 billing questions

How is actigraphy different from an unattended sleep study?

Actigraphy tracks movement over time to estimate sleep and wake patterns. An unattended sleep study, such as 95800 or 95806, records physiologic data used to evaluate sleep-related breathing or other sleep-study questions.

Can 95803 be reported with modifier 26 or TC?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the code represents the global service.

What recording duration supports this code?

The test involves at least 72 hours of actigraphy recording, followed by analysis, interpretation, and a report. Document the actual recording period and resulting findings.

Does actigraphy measure sleep stages or breathing?

No. It estimates sleep and wake from recorded movement; it does not provide sleep-stage or respiratory-event measurements like polysomnography or a sleep apnea test.

What documentation should accompany the claim?

Document the clinical sleep-wake question, recording period, analysis and interpretation, and findings. For a component claim, identify whether the service was professional interpretation or technical equipment and staff.

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 95803PPRRVU2026_Oct_nonQPP.csv, line 12,529 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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