$130.59
Both are unattended sleep studies, but 95800 includes sleep-time measurement. This code is identified by simultaneous heart-rate, oxygen-saturation, airflow, and respiratory-effort recording.
On this page
CMS RVU26D · Effective 2026-10-01
95806 Sleep study Medicare reimbursement rates in Iowa
Report this unattended sleep study when a portable test simultaneously records heart rate, oxygen saturation, airflow, and respiratory effort to assess sleep-disordered breathing. Compare 95806 office and facility rates across CMS payment localities in Iowa.
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 95806 in Iowa?
Iowa 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
$95.98
1 of 1 localities have a supported rate.
Payment area: Iowa
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 95806: Unattended cardiorespiratory sleep study
Report this unattended sleep study when a portable test simultaneously records heart rate, oxygen saturation, airflow, and respiratory effort to assess sleep-disordered breathing.
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.
CMS billing rules for 95806
- 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 RVU0.91 · 29%
- Practice expense (office) RVU2.12 · 69%
- Malpractice RVU0.06 · 2%
93.7K
Medicare services in 2024 · #583 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.
95806 compared with similar codes
Office rates for Iowa, from the same CMS release.
$96.37
Code 95801 allows a minimum of three channels with respiratory-analysis signal choices. Choose this code when the recorded study includes its specified four-signal combination.
$406.47
Code 95807 is an attended sleep study. This code describes an unattended recording, commonly collected with a portable monitor.
$618.86
Code 95810 is attended laboratory polysomnography for patients age six or older, with four or more parameters. This code is for the specified unattended cardiorespiratory recording.
Compare 95806 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
Iowa →
Office / nonfacility
$95.98
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 95806 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
12,535
- Code
- 95806
- Physician work
- 0.91
- Practice expense
- 2.12
- Malpractice
- 0.06
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.91 | × 1.000 | 0.9100 |
| Practice expense | 2.12 | × 0.915 | 1.9398 |
| Malpractice | 0.06 | × 0.397 | 0.0238 |
| Total RVUs | 2.8736 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$95.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.91 | 1 |
| Practice expense | 2.12 | 0.915 |
| Malpractice | 0.06 | 0.397 |
(0.91 × 1 + 2.12 × 0.915 + 0.06 × 0.397) × $33.4009 = $95.98
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.
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 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.
12,53295805,,Multiple sleep latency test,A,,1.17,13.02,,13.02,NA,0.17,14.36,14.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,53395805,26,Multiple sleep latency test,A,,1.17,0.51,,0.51,,0.05,1.73,1.73,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,53495805,TC,Multiple sleep latency test,A,,0.00,12.51,,12.51,NA,0.12,12.63,12.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,53595806,,Sleep study unatt&resp efft,A,,0.91,2.12,,2.12,NA,0.06,3.09,3.09,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,53695806,26,Sleep study unatt&resp efft,A,,0.91,0.39,,0.39,,0.04,1.34,1.34,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,53795806,TC,Sleep study unatt&resp efft,A,,0.00,1.73,,1.73,NA,0.02,1.75,1.75,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,53895807,,Sleep study attended,A,,1.25,11.86,,11.86,NA,0.17,13.28,13.28,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136