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CPT 95810: Polysomnography, Overnight Diagnostic Sleep Study
CPT code 95810 represents comprehensive polysomnography—an attended, overnight diagnostic sleep study lasting six or more hours with physician review, interpretation, and report. Polysomnography is a core diagnostic tool for evaluating a wide range of sleep disorders, including sleep apnea and hypersomnias, and therefore has broad national relevance for clinical care pathways, preoperative evaluations, and chronic disease management.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical scope of 95810, how it differs from related polysomnography and sleep staging codes, and which typical clinical settings perform the service. The publication also summarizes common billing relationships and comparative code context to help clarify when 95810 is appropriate versus other polysomnography or sleep staging codes.
The report provides actionable benchmarks and policy context relevant to national payer coverage patterns, documentation and reporting expectations, and typical utilization scenarios. It highlights where 95810 sits in the coding landscape and what payers commonly expect for an attended, overnight diagnostic polysomnography with physician interpretation.
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Billing Code Overview
CPT code 95810 describes polysomnography, the continuous and simultaneous monitoring and recording of multiple physiological and pathophysiological parameters of sleep for six or more hours with physician review, interpretation, and report. This service is a diagnostic, physician-reviewed sleep study that captures comprehensive overnight sleep data.
Service type: Diagnostic polysomnography with physician interpretation and report
Typical site of service: Sleep laboratory or accredited sleep center (overnight monitoring, attended)
National Reimbursement Benchmarks
Across national benchmarks, Medicare's mean rate for CPT 95810 sits near $468.70 while BUCA's average commercial mean is substantially higher at $1,372.80, highlighting a marked gap between public program reimbursement and the BUCA commercial average. Median values differ as well where available, reflecting that commercial arrangements tend to cluster at higher central tendencies than Medicare for this code.
Rate dispersion (P75 minus P25) varies notably by payer: Blue Cross Blue Shield shows one of the widest interquartile spreads at $581.70 (P75 $2,134.90 minus P25 $1,553.20), followed by UnitedHealth Group with a spread of $549.60 (P75 $920.80 minus P25 $297.20). Aetna and Cigna are tighter by comparison, with spreads of $478.40 and $761.10 respectively, indicating more concentrated versus more variable commercial pricing across payers.