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See a sample rate comparisonCPT 95807 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Sleep Study, A Sleep Study Records Information About Breathing Effort And Ability Heart Rate And Amount Of Oxygen That Is In The Blood While Sleeping. Data May Be Recorded Automatically Or By An Attendant.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 52 - Reduced Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $443.56 national non-facility rate (2026) · View Medicare rates for 95807 |
| Medicaid Fee Schedule | $356.95 median of the 8 states in the free preview · View Medicaid rates for 95807 |
National average reimbursement for CPT 95807 by major payers:
$429.90
$572.11
$554.99
$708.61
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CPT 95807
5 of 25 sample ratesHigher to lower in this preview
Jennings Nestor
Moses Cone Medical Services Inc
$1,277.47Published rateDavid Zaas
Wake Forest University Health Sciences
$713.01Published rateSouth Carolina Sleep Medicine LLC
$448.48Published rateWilliam Meredith
Prisma Health-University Medical Group
$88.55Published rateAnsible Health Medical Group PA
$50.27Published rate
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See a sample payer proposalCPT 95807 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95807 code is part of the Medicine Services and Procedures services used for Neurology and Neuromuscular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 95807 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 95806-CPT | Low | Sleep Study, A Sleep Study Records Information About Breathing Effort And Ability Heart Rate And Amount Of Oxygen That Is In The Blood While Sleeping. Data May Be Recorded Automatically Or By An Attendant. |
| 95807-CPT | Moderate | Sleep Study, A Sleep Study Records Information About Breathing Effort And Ability Heart Rate And Amount Of Oxygen That Is In The Blood While Sleeping. Data May Be Recorded Automatically Or By An Attendant. |
| 95810-CPT | Moderate | Overnight Sleep Study, A Technician-Monitored Overnight Sleep Study At A Facility. Brain Activity Breathing Blood Pressure Heart Rate And Other Factors Are Measured As Well As The Quality Of Sleep. |
| 95811-CPT | Moderate | Polysom 6 Yrs Cpap 4 Parm, Polysomnography Age 6 Years Or Older Sleep Staging With 4 Or More Additional Parameters Of Sleep With Initiation Of Continuous Positive Airway Pressure Therapy Or Bilevel Ventilation Attended By A Technologist |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95807. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95807 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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