Billing code 95783: Pediatric sleep studyMedicare rate & RVUs in Oklahoma
Attended polysomnography for a child younger than six that includes sleep staging, multiple physiologic measurements, and initiation or adjustment of PAP therapy.
Medicare pays $963.27 for 95783 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.
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 9 sections
What 95783 covers
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.
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 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $963.27 | Unavailable |
How the 95783 rate is calculated
Each of 95783’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 · 95783
RVUs × geographic indexes × conversion factor
Work2.76
2.76 RVUs× 1.000 GPCI
Practice expense28.90
28.90 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
32.0100
Conversion factor
$33.4009
Medicare rate
$1,069.16
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95783
The CMS indicators that decide how 95783 is paid alongside other services.
CMS payment indicators · 95783
Pediatric sleep study
| 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
95783 without 26 · national office
$1,069.16
Pediatric sleep study
95783-26 · Professional component
$131.27
Pays only the interpretation and report.
95783 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95782Sleep study
- 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.
- 95811Sleep study
- 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.
- 95810Sleep study
- 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.
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 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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