$937.33
Both are pediatric attended sleep studies with sleep staging and multiple physiologic measurements. Choose 95783 when the study includes PAP or bilevel titration; 95782 is the diagnostic-only study.
On this page
CMS RVU26D · Effective 2026-10-01
95783 Pediatric sleep study Medicare reimbursement rates in Indiana
Attended polysomnography for a child younger than six that includes sleep staging, multiple physiologic measurements, and initiation or adjustment of PAP therapy. Compare 95783 office and facility rates across CMS payment localities in Indiana.
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 95783 in Indiana?
Indiana 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
$992.69
1 of 1 localities have a supported rate.
Payment area: Indiana
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 95783: Pediatric polysomnography with PAP titration
Attended polysomnography for a child younger than six that includes sleep staging, multiple physiologic measurements, and initiation or adjustment of PAP therapy.
This attended sleep-laboratory study is for a child younger than six and combines sleep staging with at least four additional physiologic measurements and initiation or adjustment of continuous positive airway pressure or bilevel ventilation. A technologist monitors the child during the study; recorded signals may include airflow, respiratory effort, oxygen saturation, ECG, and limb muscle activity. A sleep physician interprets the recording, often when evaluating obstructive sleep apnea or another sleep-related breathing disorder requiring PAP titration.
Report this code for the qualifying pediatric study with PAP titration, rather than the diagnostic-only pediatric study. The record should support the patient’s age, attended monitoring, sleep staging and additional parameters, and the PAP or bilevel titration performed. CMS recognizes separately priced professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service.
CMS billing rules for 95783
- 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 RVU2.76 · 9%
- Practice expense (office) RVU28.90 · 90%
- Malpractice RVU0.35 · 1%
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.
95783 compared with similar codes
Office rates for Indiana, from the same CMS release.
$658.17
Both include attended polysomnography with PAP titration. The age distinction separates them: 95783 is for children younger than six, while 95811 is for patients age six and older.
$626.64
Code 95810 is diagnostic attended polysomnography for patients age six and older without PAP titration. It differs from 95783 in both patient age and the inclusion of titration.
Compare 95783 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
Indiana →
Office / nonfacility
$992.69
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 95783 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
12,520
- Code
- 95783
- Physician work
- 2.76
- Practice expense
- 28.90
- Malpractice
- 0.35
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.76 | × 1.000 | 2.7600 |
| Practice expense | 28.90 | × 0.927 | 26.7903 |
| Malpractice | 0.35 | × 0.486 | 0.1701 |
| Total RVUs | 29.7204 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$992.69
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.76 | 1 |
| Practice expense | 28.9 | 0.927 |
| Malpractice | 0.35 | 0.486 |
(2.76 × 1 + 28.9 × 0.927 + 0.35 × 0.486) × $33.4009 = $992.69
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.
95783 billing questions
When should this be chosen instead of 95782?
Use this code when the attended study for a child younger than six includes initiation or adjustment of CPAP or bilevel ventilation. Code 95782 describes the pediatric study without PAP titration.
Can the professional and technical services be billed separately?
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 reporting this code?
Document the child’s age, attended monitoring, sleep staging, the additional physiologic parameters recorded, and the PAP or bilevel titration performed.
Is the diagnostic portion reported separately when titration occurs?
This code describes the pediatric polysomnography that includes PAP titration. Do not treat the diagnostic-only pediatric study code as interchangeable with it.
How does this differ from 95811?
Both describe attended polysomnography with PAP titration, but this code is for children younger than six. Code 95811 is the corresponding study for patients age six and older.
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.
12,51795782,,Polysom <6 yrs 4/> paramtrs,A,,2.54,27.36,,27.36,NA,0.33,30.23,30.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,51895782,26,Polysom <6 yrs 4/> paramtrs,A,,2.54,1.02,,1.02,,0.06,3.62,3.62,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,51995782,TC,Polysom <6 yrs 4/> paramtrs,A,,0.00,26.34,,26.34,NA,0.27,26.61,26.61,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,52095783,,Polysom <6 yrs cpap/bilvl,A,,2.76,28.90,,28.90,NA,0.35,32.01,32.01,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52195783,26,Polysom <6 yrs cpap/bilvl,A,,2.76,1.10,,1.10,,0.07,3.93,3.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52295783,TC,Polysom <6 yrs cpap/bilvl,A,,0.00,27.80,,27.80,NA,0.28,28.08,28.08,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,52395800,,Slp stdy unattended,A,,0.83,3.34,,3.34,NA,0.06,4.23,4.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915