CPT code 95806: Sleep study, heart rate and respiratory signals2026 Medicare rate & RVUs in South Carolina
Report this unattended sleep study when a portable test simultaneously records heart rate, oxygen saturation, airflow, and respiratory effort to assess sleep-disordered breathing.
In South Carolina, Medicare pays $97.53 for 95806 in the office.
Check a contract rate as a % of Medicare · 95806 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 95806 covers
This unattended test records heart rate, oxygen saturation, respiratory airflow, and respiratory effort at the same time. It is commonly performed with a portable monitor in a patient’s home to evaluate suspected sleep-disordered breathing, including obstructive sleep apnea. Clinical staff may prepare the equipment and instruct the patient, while a qualified practitioner interprets the recorded data. The patient is not continuously attended by a technologist during the recording.
Select this code when the study includes the specified combination of signals; document the test performed and retain the recording and interpretation. It differs from unattended studies with other signal sets and from attended laboratory studies. The global service is billed without a component modifier. Modifier 26 identifies the professional interpretation, while modifier TC identifies the equipment and staff component; CMS separately prices both modifiers.
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 South Carolina compares for 95806
Across 109 of 109 payment localities, the office rate for 95806 runs from $92.25 in Arkansas to $136.92 in San Benito County, CA. South Carolina pays $97.53. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$97.53
- Los Angeles, CA · California$116.74+$19.21
- Washington, DC area · District of Columbia$117.68+$20.15
- Miami, FL · Florida$109.18+$11.65
- Chicago, IL · Illinois$106.37+$8.84
- Manhattan, NY · New York$117.80+$20.27
- Alaska · Alaska$122.11+$24.58
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $93.49 | — |
| ArkansasArkansas | $92.25 | — |
| ArizonaArizona | $100.73 | — |
| Bakersfield, CACalifornia | $109.80 | — |
| Chico, CACalifornia | $109.59 | — |
| El Centro, CACalifornia | $109.60 | — |
| Fresno, CACalifornia | $109.59 | — |
| Hanford, CACalifornia | $109.59 | — |
| Madera, CACalifornia | $109.59 | — |
| Merced, CACalifornia | $109.59 | — |
| Modesto, CACalifornia | $109.59 | — |
| Napa, CACalifornia | $126.66 | — |
| Oxnard, CACalifornia | $116.19 | — |
| Redding, CACalifornia | $109.59 | — |
| Rest of CaliforniaCalifornia | $109.59 | — |
| Riverside, CACalifornia | $110.26 | — |
| Sacramento, CACalifornia | $114.92 | — |
| Salinas, CACalifornia | $114.48 | — |
| San Diego, CACalifornia | $117.08 | — |
| Marin County, CACalifornia | $134.04 | — |
| San Francisco, CACalifornia | $133.98 | — |
| San Benito County, CACalifornia | $136.92 | — |
| Santa Clara County, CACalifornia | $136.64 | — |
| San Luis Obispo, CACalifornia | $112.64 | — |
| Santa Cruz, CACalifornia | $118.14 | — |
| Santa Maria, CACalifornia | $114.88 | — |
| Santa Rosa, CACalifornia | $119.34 | — |
| Stockton, CACalifornia | $109.59 | — |
| Vallejo, CACalifornia | $126.56 | — |
| Visalia, CACalifornia | $109.59 | — |
| Yuba City, CACalifornia | $109.59 | — |
| ColoradoColorado | $107.67 | — |
| ConnecticutConnecticut | $109.69 | — |
| DelawareDelaware | $102.31 | — |
| Fort Lauderdale, FLFlorida | $105.75 | — |
| Rest of FloridaFlorida | $101.10 | — |
| Atlanta, GAGeorgia | $104.84 | — |
| Rest of GeorgiaGeorgia | $95.95 | — |
| Hawaii, Guam, HIHawaii | $112.07 | — |
| IowaIowa | $95.98 | — |
| IdahoIdaho | $96.49 | — |
| East St. Louis, ILIllinois | $99.58 | — |
| Rest of IllinoisIllinois | $98.18 | — |
| Suburban Chicago, ILIllinois | $106.88 | — |
| IndianaIndiana | $97.01 | — |
| KansasKansas | $95.42 | — |
| KentuckyKentucky | $95.18 | — |
| New Orleans, LALouisiana | $99.30 | — |
| Rest of LouisianaLouisiana | $94.98 | — |
| Metropolitan Boston, MAMassachusetts | $117.97 | — |
| Rest of MassachusettsMassachusetts | $107.04 | — |
| Baltimore area, MDMaryland | $109.34 | — |
| Rest of MarylandMaryland | $104.20 | — |
| Rest of MaineMaine | $96.79 | — |
| Southern Maine, MEMaine | $101.83 | — |
| Detroit, MIMichigan | $102.11 | — |
| Rest of MichiganMichigan | $97.31 | — |
| MinnesotaMinnesota | $103.85 | — |
| Metropolitan Kansas City, MOMissouri | $98.84 | — |
| Metropolitan St. Louis, MOMissouri | $99.81 | — |
| Rest of MissouriMissouri | $93.38 | — |
| MississippiMississippi | $92.84 | — |
| MontanaMontana | $103.20 | — |
| North CarolinaNorth Carolina | $97.74 | — |
| North DakotaNorth Dakota | $102.02 | — |
| NebraskaNebraska | $96.51 | — |
| New HampshireNew Hampshire | $105.86 | — |
| Northern New JerseyNew Jersey | $116.59 | — |
| Rest of New JerseyNew Jersey | $111.13 | — |
| New MexicoNew Mexico | $97.73 | — |
| NevadaNevada | $102.94 | — |
| NYC suburbs and Long Island, NYNew York | $120.25 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $111.72 | — |
| Queens, NYNew York | $118.93 | — |
| Rest of New YorkNew York | $99.07 | — |
| OhioOhio | $97.06 | — |
| OklahomaOklahoma | $95.19 | — |
| Portland, OROregon | $111.04 | — |
| Rest of OregonOregon | $102.33 | — |
| Metropolitan Philadelphia, PAPennsylvania | $107.05 | — |
| Rest of PennsylvaniaPennsylvania | $97.29 | — |
| Puerto RicoPuerto Rico | $103.96 | — |
| Rhode IslandRhode Island | $105.91 | — |
| South DakotaSouth Dakota | $101.88 | — |
| TennesseeTennessee | $95.84 | — |
| Austin, TXTexas | $107.15 | — |
| Beaumont, TXTexas | $96.69 | — |
| Brazoria, TXTexas | $102.37 | — |
| Dallas, TXTexas | $102.91 | — |
| Fort Worth, TXTexas | $102.23 | — |
| Galveston, TXTexas | $102.61 | — |
| Houston, TXTexas | $103.71 | — |
| Rest of TexasTexas | $99.40 | — |
| UtahUtah | $98.76 | — |
| VirginiaVirginia | $101.42 | — |
| Virgin Islands, VIUnited States Virgin Islands | $103.96 | — |
| VermontVermont | $101.51 | — |
| Rest of WashingtonWashington | $106.88 | — |
| King County, WAWashington | $120.44 | — |
| WisconsinWisconsin | $98.85 | — |
| West VirginiaWest Virginia | $94.80 | — |
| WyomingWyoming | $102.69 | — |
95806 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.
$92.25
$123.26
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 | $122.11 | 1 |
| AL | $93.49 | 1 |
| AR | $92.25 | 1 |
| AZ | $100.73 | 1 |
| CA | $109.59–$136.92 | 29 |
| CO | $107.67 | 1 |
| CT | $109.69 | 1 |
| DC | $117.68 | 1 |
| DE | $102.31 | 1 |
| FL | $101.10–$109.18 | 3 |
| GA | $95.95–$104.84 | 2 |
| GU | $112.07 | 1 |
| HI | $112.07 | 1 |
| IA | $95.98 | 1 |
| ID | $96.49 | 1 |
| IL | $98.18–$106.88 | 4 |
| IN | $97.01 | 1 |
| KS | $95.42 | 1 |
| KY | $95.18 | 1 |
| LA | $94.98–$99.30 | 2 |
| MA | $107.04–$117.97 | 2 |
| MD | $104.20–$117.68 | 3 |
| ME | $96.79–$101.83 | 2 |
| MI | $97.31–$102.11 | 2 |
| MN | $103.85 | 1 |
| MO | $93.38–$99.81 | 3 |
| MS | $92.84 | 1 |
| MT | $103.20 | 1 |
| NC | $97.74 | 1 |
| ND | $102.02 | 1 |
| NE | $96.51 | 1 |
| NH | $105.86 | 1 |
| NJ | $111.13–$116.59 | 2 |
| NM | $97.73 | 1 |
| NV | $102.94 | 1 |
| NY | $99.07–$120.25 | 5 |
| OH | $97.06 | 1 |
| OK | $95.19 | 1 |
| OR | $102.33–$111.04 | 2 |
| PA | $97.29–$107.05 | 2 |
| PR | $103.96 | 1 |
| RI | $105.91 | 1 |
| SC | $97.53 | 1 |
| SD | $101.88 | 1 |
| TN | $95.84 | 1 |
| TX | $96.69–$107.15 | 8 |
| UT | $98.76 | 1 |
| VA | $101.42–$117.68 | 2 |
| VI | $103.96 | 1 |
| VT | $101.51 | 1 |
| WA | $106.88–$120.44 | 2 |
| WI | $98.85 | 1 |
| WV | $94.80 | 1 |
| WY | $102.69 | 1 |
How the 95806 rate is calculated
Each of 95806’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 · 95806
RVUs × geographic indexes × conversion factor
Work0.91
0.91 RVUs× 1.000 GPCI
Practice expense2.12
2.12 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
3.0900
Conversion factor
$33.4009
Medicare rate
$103.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,535
- Code
- 95806
- Physician work
- 0.91
- Practice expense
- 2.12
- Malpractice
- 0.06
GPCI2026.csv
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.91 | × 1.000 | 0.9100 |
| Practice expense | 2.12 | × 0.924 | 1.9589 |
| Malpractice | 0.06 | × 0.850 | 0.0510 |
| Total RVUs | 2.9199 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$97.53
Office: (0.91 × 1 + 2.12 × 0.924 + 0.06 × 0.85) × $33.4009 = $97.53
Payment rules and modifiers for 95806
The CMS indicators that decide how 95806 is paid alongside other services.
CMS payment indicators · 95806
Sleep study, heart rate and respiratory signals
| 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
95806 without 26 · national office
$103.21
Sleep study, heart rate and respiratory signals
95806-26 · Professional component
$44.76
Pays only the interpretation and report.
How 95806 has changed in South Carolina
95806 · Office / nonfacility
$97.53
Effective 2026-10-01
The base rate is $10.01 higher than on 2025-10-01, moving from $87.52 to $97.53 (11.4%).
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
$87.52changed to$97.53
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.93 changed to 0.91
- Practice expense RVU 1.90 changed to 2.12
- Malpractice RVU 0.05 changed to 0.06
- Practice expense GPCI 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$88.54changed to$87.52
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.85 changed to 1.90
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$87.10changed to$88.54
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$86.90changed to$87.10
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.75 changed to 1.85
- Malpractice RVU 0.06 changed to 0.05
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$87.06changed to$86.90
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.71 changed to 1.75
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$95.35changed to$87.06
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.95 changed to 1.71
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$110.73changed to$95.35
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.33 changed to 1.95
- Malpractice RVU 0.04 changed to 0.06
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$130.49changed to$110.73
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.92 changed to 2.33
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.912 changed to 0.907
- Malpractice GPCI 0.553 changed to 0.624
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$161.43changed to$130.49
- Conversion factor 35.9996 changed to 36.0391
- Work RVU 1.25 changed to 0.93
- Practice expense RVU 3.51 changed to 2.92
- Malpractice RVU 0.06 changed to 0.05
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$160.13changed to$161.43
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.48 changed to 3.51
- Malpractice GPCI 0.634 changed to 0.553
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$158.95changed to$160.13
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.45 changed to 3.48
- Malpractice GPCI 0.715 changed to 0.634
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$158.93changed to$158.95
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.44 changed to 3.45
- Malpractice RVU 0.05 changed to 0.06
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$158.14changed to$158.93
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$160.77changed to$158.14
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.50 changed to 3.44
- Malpractice RVU 0.08 changed to 0.05
- Practice expense GPCI 0.911 changed to 0.912
- Malpractice GPCI 0.618 changed to 0.715
Held through RVU15B.
January 1, 2014
RVU14A
$169.51changed to$160.77
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 4.06 changed to 3.50
- Practice expense GPCI 0.909 changed to 0.911
- Malpractice GPCI 0.520 changed to 0.618
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $169.51
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $97.53 | Not available in this setting | RVU26D |
| 2026-07-01 | $97.53 | Not available in this setting | RVU26C |
| 2026-04-01 | $97.53 | Not available in this setting | RVU26B |
| 2026-01-01 | $97.53 | Not available in this setting | RVU26A |
| 2025-10-01 | $87.52 | Not available in this setting | RVU25D |
| 2025-07-01 | $87.52 | Not available in this setting | RVU25C |
| 2025-04-01 | $87.52 | Not available in this setting | RVU25B |
| 2025-01-01 | $87.52 | Not available in this setting | RVU25A |
| 2024-10-01 | $88.54 | Not available in this setting | RVU24D |
| 2024-07-01 | $88.54 | Not available in this setting | RVU24C |
| 2024-04-01 | $88.54 | Not available in this setting | RVU24B |
| 2024-03-09 | $88.54 | Not available in this setting | RVU24AR |
| 2024-01-01 | $87.10 | Not available in this setting | RVU24A |
| 2023-10-01 | $86.90 | Not available in this setting | RVU23D |
| 2023-07-01 | $86.90 | Not available in this setting | RVU23C |
| 2023-04-01 | $86.90 | Not available in this setting | RVU23B |
| 2023-01-01 | $86.90 | Not available in this setting | RVU23A |
| 2022-10-01 | $87.06 | Not available in this setting | RVU22D |
| 2022-07-01 | $87.06 | Not available in this setting | RVU22C |
| 2022-04-01 | $87.06 | Not available in this setting | RVU22B |
| 2022-01-01 | $87.06 | Not available in this setting | RVU22A |
| 2021-10-01 | $95.35 | Not available in this setting | RVU21D |
| 2021-07-01 | $95.35 | Not available in this setting | RVU21C |
| 2021-04-01 | $95.35 | Not available in this setting | RVU21B |
| 2021-01-01 | $95.35 | Not available in this setting | RVU21A |
| 2020-10-01 | $110.73 | Not available in this setting | RVU20D |
| 2020-07-01 | $110.73 | Not available in this setting | RVU20C |
| 2020-04-01 | $110.73 | Not available in this setting | RVU20B |
| 2020-01-01 | $110.73 | Not available in this setting | RVU20A |
| 2019-10-01 | $130.49 | Not available in this setting | RVU19D |
| 2019-07-01 | $130.49 | Not available in this setting | RVU19C |
| 2019-04-01 | $130.49 | Not available in this setting | RVU19B |
| 2019-01-01 | $130.49 | Not available in this setting | RVU19A |
| 2018-10-01 | $161.43 | Not available in this setting | RVU18D |
| 2018-07-01 | $161.43 | Not available in this setting | RVU18C |
| 2018-04-01 | $161.43 | Not available in this setting | RVU18B |
| 2018-01-01 | $161.43 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $160.13 | Not available in this setting | RVU17D |
| 2017-07-01 | $160.13 | Not available in this setting | RVU17C |
| 2017-04-01 | $160.13 | Not available in this setting | RVU17B |
| 2017-01-01 | $160.13 | Not available in this setting | RVU17A |
| 2016-10-01 | $158.95 | Not available in this setting | RVU16D |
| 2016-07-01 | $158.95 | Not available in this setting | RVU16C |
| 2016-04-01 | $158.95 | Not available in this setting | RVU16B |
| 2016-01-01 | $158.95 | Not available in this setting | RVU16A |
| 2015-10-01 | $158.93 | Not available in this setting | RVU15D |
| 2015-07-01 | $158.93 | Not available in this setting | RVU15C |
| 2015-04-01 | $158.14 | Not available in this setting | RVU15B |
| 2015-01-01 | $158.14 | Not available in this setting | RVU15A |
| 2014-10-01 | $160.77 | Not available in this setting | RVU14D |
| 2014-07-01 | $160.77 | Not available in this setting | RVU14C |
| 2014-04-01 | $160.77 | Not available in this setting | RVU14B |
| 2014-01-01 | $160.77 | Not available in this setting | RVU14A |
| 2013-10-01 | $169.51 | Not available in this setting | RVU13D |
| 2013-07-01 | $169.51 | Not available in this setting | RVU13C |
| 2013-04-01 | $169.51 | Not available in this setting | RVU13B |
| 2013-01-01 | $169.51 | Not available in this setting | RVU13AR |
Where the South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
95806 billing questions
How does this differ from 95800?
This code is for simultaneous recording of heart rate, oxygen saturation, airflow, and respiratory effort. Code 95800 is an unattended study that includes sleep-time measurement.
How does this differ from 95801?
Code 95801 covers an unattended study with a minimum of three channels and a broader choice of respiratory-analysis signals. Use this code when the study records the specific heart-rate, oxygen-saturation, airflow, and respiratory-effort combination.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Bill without either modifier when reporting the global service.
Is this the code for an attended sleep-laboratory study?
No. This code describes an unattended recording. An attended study, such as 95807 or 95810, is selected when the patient is monitored in a sleep laboratory.
What documentation supports reporting this code?
Document that the study was unattended and that the recording included heart rate, oxygen saturation, airflow, and respiratory effort. Keep the test data and the interpreting practitioner’s report.
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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