CPT 95783
Global XXX ActivePolysom <6 yrs cpap/bilvl
CPT 95783 Billing & Documentation Guide
CPT code 95783 (Polysom <6 yrs cpap/bilvl) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.76, a non-facility practice expense RVU of 28.9, and a malpractice RVU of 0.35, a total non-facility RVU of 32.01 and facility RVU of 32.01. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1111.48, though rates vary from $927.39 to $1500.54 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95783, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 95783 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95783 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 95783
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.76 | 2.76 |
| Practice Expense RVU | 28.9 | 28.9 |
| Malpractice RVU | 0.35 | 0.35 |
| Total RVU | 32.01 | 32.01 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95783
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1244.03 | $1244.03 | $1157.97 - $1500.54 | 29 |
| Florida | $1083.45 | $1083.45 | $1032.57 - $1126.61 | 3 |
| Georgia | $1027.2 | $1027.2 | $967.16 - $1087.23 | 2 |
| Illinois | $1047.55 | $1047.55 | $991.76 - $1104.9 | 4 |
| Michigan | $1015.05 | $1015.05 | $986.69 - $1043.4 | 2 |
| North Carolina | $1000.27 | $1000.27 | $1000.27 - $1000.27 | 1 |
| New York | $1189.32 | $1189.32 | $1017.43 - $1267.52 | 5 |
| Ohio | $985.28 | $985.28 | $985.28 - $985.28 | 1 |
| Pennsylvania | $1051.02 | $1051.02 | $989.37 - $1112.66 | 2 |
| Texas | $1053.88 | $1053.88 | $981.46 - $1124 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 95783
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95783 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0178T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0179T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0180T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0243T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0244T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0295T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0296T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0297T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0298T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 95783
What does CPT code 95783 mean? +
CPT code 95783 represents: Polysom <6 yrs cpap/bilvl. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95783? +
The 2026 Medicare national average non-facility payment for CPT 95783 is $1111.48. Rates range from $927.39 to $1500.54 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95783? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 95783? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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