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See a sample rate comparisonCPT 95811 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.
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
| 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 | None 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 95811 |
| Medicaid Fee Schedule | View Medicaid rates for 95811 |
National average reimbursement for CPT 95811 by major payers:
$695.59
$896.03
$953.46
$1,119.36
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CPT 95811
5 of 25 sample ratesHigher to lower in this preview
Paula Watson
Vanderbilt University Medical Center
$1,732.17Published rateConnor Snarskis
Vanderbilt University Medical Center
$1,366.56Published rateKumar Ramdas
Orion Healthcare LLC
$581.97Published rateJodi Robbe
Vanderbilt University Medical Center
$310.76Published rateAndrew Romano
Dr Andrew L Romano Do LLC
$99.01Published rate
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See a sample payer proposalCPT 95811 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95811 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 95811 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 |
|---|---|---|
| 95782-CPT | High | 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. |
| 95783-CPT | High | Polysom 6 Yrs Cpap Bilvl, Polysomnography Younger Than 6 Years Sleep Staging With 4 Or More Additional Parameters Of Sleep With Initiation Of Continuous Positive Airway Pressure Therapy Or Bi Level Ventilation Attended By A Technologist |
| 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 95811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95811 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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