$1,053.73
Both codes describe attended polysomnography for children younger than six. Choose 95783 when PAP or bilevel titration is part of the study; 95782 is diagnostic without that titration.
On this page
CMS RVU26D · Effective 2026-10-01
95782 Sleep study Medicare reimbursement rates in Vermont
Reports an attended diagnostic polysomnographic study for a child younger than six, with sleep staging and at least four additional physiologic parameters. Compare 95782 office and facility rates across CMS payment localities in Vermont.
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 95782 in Vermont?
Vermont 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
$995.13
1 of 1 localities have a supported rate.
Payment area: Vermont
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 95782: Pediatric diagnostic polysomnography
Reports an attended diagnostic polysomnographic study for a child younger than six, with sleep staging and at least four additional physiologic parameters.
95782 is an attended polysomnographic study for a child younger than six when the evaluation includes sleep staging and at least four additional physiologic parameters. A sleep technologist applies and monitors sensors during the study, typically in a sleep laboratory or hospital. Sleep specialists use it to evaluate concerns such as snoring, witnessed breathing pauses, labored breathing, or unexplained oxygen desaturation during sleep. Recorded channels may assess airflow, respiratory effort, oxygen saturation, heart rhythm, and muscle activity.
Choose this code based on the child’s age and the diagnostic study performed, rather than the number of recorded hours or channels alone. The record should support the patient’s age, attended study, monitored parameters, and physician interpretation. CMS recognizes separately priced professional and technical components: modifier 26 identifies interpretation, and modifier TC identifies equipment and staff. Reporting without either modifier represents the global service.
CMS billing rules for 95782
- 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 RVU2.54 · 8%
- Practice expense (office) RVU27.36 · 91%
- Malpractice RVU0.33 · 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.
95782 compared with similar codes
Office rates for Vermont, from the same CMS release.
$663.57
This is the diagnostic attended polysomnography counterpart for patients age six or older. The age distinction separates it from 95782.
$697.01
This code describes attended polysomnography with PAP titration for patients age six or older; 95782 is for a younger child’s diagnostic study.
$436.80
95807 describes a limited attended sleep recording. Use 95782 for the qualifying pediatric polysomnographic study with sleep staging and at least four additional parameters.
Compare 95782 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
Vermont →
Office / nonfacility
$995.13
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 95782 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
12,517
- Code
- 95782
- Physician work
- 2.54
- Practice expense
- 27.36
- Malpractice
- 0.33
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.54 | × 1.000 | 2.5400 |
| Practice expense | 27.36 | × 0.990 | 27.0864 |
| Malpractice | 0.33 | × 0.506 | 0.1670 |
| Total RVUs | 29.7934 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$995.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.54 | 1 |
| Practice expense | 27.36 | 0.99 |
| Malpractice | 0.33 | 0.506 |
(2.54 × 1 + 27.36 × 0.99 + 0.33 × 0.506) × $33.4009 = $995.13
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.
95782 billing questions
How does 95782 differ from 95783?
95782 is for a diagnostic study in a child younger than six. Use 95783 when the study includes PAP or bilevel titration.
Can the interpretation and technical service 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 code represents the global service.
Is this reported per hour or per monitoring channel?
No. The code describes the qualifying attended polysomnographic study, not separate units for each hour or recorded channel.
What documentation supports 95782?
Document that the child was younger than six, that the study was attended, and that it included sleep staging plus at least four additional physiologic parameters. Retain the study record and physician interpretation.
When would 95810 be a better fit?
95810 is the corresponding diagnostic polysomnography code for a patient age six or older. For a child younger than six, use 95782 when the study meets its diagnostic criteria.
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.
12,51495724,,Eeg phy/qhp>60<84 hr w/veeg,A,,6.00,3.54,,1.68,,0.46,10.00,8.14,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,51595725,,Eeg phy/qhp>84 hr w/o vid,A,,5.40,3.30,,1.56,,0.43,9.13,7.39,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,51695726,,Eeg phy/qhp>84 hr w/veeg,A,,7.58,4.59,,2.17,,0.60,12.77,10.35,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,51795782,,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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817