Sleep Study (Polysomnography) price: Medicare anchor and facility lever
Anchor for Sleep Study (Polysomnography) - CPT 95810
$659.23
Professional (26) $120.89 plus technical (TC) $538.34.
Hospital OPPS facility anchor, this code billed alone: $877.34 (APC 5724, Level 4 Diagnostic Tests and Related Services; national unadjusted, before wage-index adjustment).
An attended in-lab sleep study, CPT 95810, carries a CY2026 global anchor of $659.23, and most of it is the overnight technical work. A study that adds CPAP titration the same night is a different code, 95811, and a home sleep test uses other codes entirely.
CPT code
95810
Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist
CPT 95810 is attended in-lab polysomnography with sleep staging. A study with CPAP initiation is 95811, and home sleep apnea testing uses different codes (95800, 95801, 95806). Confirm which test was ordered.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 95810 (this page) | $659.23 | $659.23 | not a surgical global | $877.34 (APC 5724) | $175.47 |
| 95811 | $692.71 | $692.71 | not a surgical global | $877.34 (APC 5724) | $175.47 |
In CY2026 the hospital APC for 95810 is 5724 at $877.34, with a minimum unadjusted copayment of $175.47. The freestanding sleep center global anchor is $659.23, of which only $120.89 is the professional interpretation, so the overnight technical component is the main thing being priced.
The CPAP titration study, 95811, maps to the same hospital APC, while its global anchor is $692.71. A split-night protocol can change which code is billed; ask how the lab codes a night that starts as diagnostic and adds CPAP.
For a Medicare patient, an in-lab study billed by a hospital sleep lab carries a minimum unadjusted facility copayment of $175.47 for 95810, plus coinsurance on the sleep physician's $120.89 interpretation. At a freestanding center billing globally, coinsurance applies once to $659.23. Because both settings involve a full night of technical work, the gap between them is smaller than for many imaging codes, but the two-bill structure still applies in a hospital.
For the CPAP titration study, 95811, the sleep physician's CY2026 professional component is $125.20; CMS Addendum B lists both 95810 and 95811 with status indicator S at APC 5724.
Inside and outside the 95810 anchor
Covered by the anchor
- Overnight attended recording and sleep staging (technical component, TC)
- Physician interpretation and written report (professional component, modifier 26)
- Standard data storage and transmission to the ordering clinician
Billed outside it
- A second night or a CPAP titration night billed under 95811
- Home sleep testing billed under a different code
- The ordering visit and follow-up visit
Why prices vary for CPT 95810
Polysomnography is a technical-heavy service: most of the global anchor is the overnight lab component. A hospital sleep lab bills the OPPS diagnostic-test APC plus the professional interpretation, while a freestanding center usually bills one global amount. Ask which structure your quote uses before you compare numbers.
Ask whether the study will be in a hospital sleep lab or a freestanding sleep center, and get the cash price for CPT 95810 in each setting in writing, including whether the physician interpretation is included.
Questions specific to Sleep study
- Is the order for a diagnostic study (95810), a CPAP titration (95811), or a home test?
- If CPAP is started partway through the night, which code will be billed?
- Is the interpretation by the sleep physician included?
- Is the lab hospital-based or freestanding?
Sleep Study (Polysomnography): billing questions
Why is a sleep study priced so much higher than other tests?
It includes a full night of attended technical monitoring. In CY2026 most of the global anchor for 95810 is the technical component, and the hospital APC is a diagnostic-test level that reflects that work.
What is the difference between 95810 and 95811?
95810 is diagnostic polysomnography. 95811 includes CPAP initiation or titration. Each has its own anchor, and both map to the same hospital APC in CY2026.
Is a home sleep test cheaper?
Home sleep apnea tests use different codes with different anchors, which are not covered on this page. Ask the ordering office which test is ordered before you compare prices.
What is the minimum Medicare hospital copayment for an in-lab sleep study?
In the CY2026 OPPS Addendum B, 95810 maps to APC 5724 with a minimum unadjusted copayment of $175.47, before wage-index adjustment. The sleep physician's coinsurance on the interpretation is separate.