$699.88
Choose 95810 for diagnostic polysomnography; choose 95811 when the study includes positive airway pressure titration.
On this page
CMS RVU26D · Effective 2026-10-01
95810 Sleep study Medicare reimbursement rates in Delaware
Reports an attended overnight diagnostic sleep study for a patient age six or older, using sleep staging and at least four additional physiologic parameters. Compare 95810 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95810 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$666.22
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Sleep medicine
About 95810: Attended diagnostic polysomnography, four or more parameters
Reports an attended overnight diagnostic sleep study for a patient age six or older, using sleep staging and at least four additional physiologic parameters.
This code describes an attended diagnostic polysomnography for a patient age six or older. A sleep technologist monitors the patient during the study, typically in a sleep laboratory, while recording sleep stages and at least four additional physiologic measures. Depending on the study, monitoring may include airflow, respiratory effort, oxygen saturation, heart rhythm, and limb activity. A sleep physician interprets the recorded data and reports the findings, such as evidence of obstructive sleep apnea or another sleep-related disorder.
Select 95810 for a diagnostic study with the required age, attendance, and monitoring scope; it is not the code for a study that includes positive airway pressure titration. Documentation should identify the patient’s age, the attended laboratory setting, the parameters recorded, and the interpretation. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 95810
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU2.44 · 12%
- Practice expense (office) RVU17.47 · 87%
- Malpractice RVU0.26 · 1%
183.4K
Medicare services in 2024 · #402 by national volume
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.
95810 compared with similar codes
Office rates for Delaware, from the same CMS release.
$506.59
95808 is the attended polysomnography code for any age with a different number of additional parameters. 95810 is for patients age six or older with the broader parameter scope.
$438.45
95807 covers attended respiratory-focused sleep monitoring without the sleep-staging scope of 95810.
$102.31
95806 is an unattended respiratory sleep study. 95810 is performed with a technologist and includes sleep staging.
Compare 95810 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
$666.22
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95810 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
12,544
- Code
- 95810
- Physician work
- 2.44
- Practice expense
- 17.47
- Malpractice
- 0.26
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.44 | × 1.005 | 2.4522 |
| Practice expense | 17.47 | × 0.988 | 17.2604 |
| Malpractice | 0.26 | × 0.899 | 0.2337 |
| Total RVUs | 19.9463 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$666.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.44 | 1.005 |
| Practice expense | 17.47 | 0.988 |
| Malpractice | 0.26 | 0.899 |
(2.44 × 1.005 + 17.47 × 0.988 + 0.26 × 0.899) × $33.4009 = $666.22
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
95810 billing questions
When should 95810 be used instead of 95811?
Use 95810 for the attended diagnostic study. Use 95811 when the study includes positive airway pressure titration.
Can the interpretation be billed separately from the sleep laboratory service?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 95810?
The record should support the patient’s age, technologist attendance, sleep staging, the additional physiologic parameters recorded, and the physician’s interpretation.
How does 95810 differ from 95807?
95810 includes sleep staging and at least four additional parameters for a patient age six or older. 95807 describes an attended sleep study focused on respiratory and related monitoring, without the same sleep-staging scope.
Is an unattended home study reported as 95810?
No. 95810 describes an attended study with a technologist. Code 95806 is an unattended sleep study focused on respiratory monitoring.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,54195808,,Polysom any age 1-3> param,A,,1.70,13.44,,13.44,NA,0.20,15.34,15.34,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,54295808,26,Polysom any age 1-3> param,A,,1.70,0.67,,0.67,,0.07,2.44,2.44,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,54395808,TC,Polysom any age 1-3> param,A,,0.00,12.77,,12.77,NA,0.13,12.90,12.90,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,54495810,,Polysom 6/> yrs 4/> param,A,,2.44,17.47,,17.47,NA,0.26,20.17,20.17,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,54595810,26,Polysom 6/> yrs 4/> param,A,,2.44,1.03,,1.03,,0.11,3.58,3.58,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,54695810,TC,Polysom 6/> yrs 4/> param,A,,0.00,16.44,,16.44,NA,0.15,16.59,16.59,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,54795811,,Polysom 6/>yrs cpap 4/> parm,A,,2.54,18.37,,18.37,NA,0.28,21.19,21.19,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503