95811
Sleep study with CPAP titration, polysomnography
Sleep study with CPAP titration, polysomnography is the #505 most-billed Medicaid procedure code, with $179.9M in payments across 530K claims from 2018–2024. The national median cost per claim is $255.03. Costs vary widely — the 90th percentile is $639.95 per claim, 2.5× the median.
Total Paid
$179.9M
0.02% of all spending
Total Claims
530K
Providers
2K
Avg Cost/Claim
$340
National Cost Distribution
How much do providers bill per claim for 95811? Based on 2K providers billing this code nationally.
Median
$255.03
Average
$318.18
Std Dev
$317.81
Max
$3,301.04
Percentile Distribution (Cost per Claim)
50% of providers bill between $90.58 and $456.55 per claim for this code.
90% bill between $61.02 and $639.95.
Top 1% bill above $1,535.43.
About This Procedure
HCPCS code 95811 (Sleep study with CPAP titration, polysomnography) was billed by 2K providers across 530K claims, totaling $179.9M in Medicaid payments from 2018–2024. This code was used for 488K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$255.03
Providers Billing
2K
National Spending
$179.9M
Avg/Median Ratio
1.25×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 95811
| # | Provider | Total Paid |
|---|---|---|
| 1 | Truman Medical Center, Incorporated Kansas City, MO · General Acute Care Hospital | $3.3M |
| 2 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $2.6M |
| 3 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $2.2M |
| 4 | 1326015777 | $2.0M |
| 5 | 1538564463 | $1.9M |
| 6 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $1.8M |
| 7 | 1922262187 | $1.7M |
| 8 | Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children | $1.7M |
| 9 | 1326261249 | $1.6M |
| 10 | 1487620928 | $1.5M |
| 11 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $1.4M |
| 12 | 1801129135 | $1.4M |
| 13 | 1124248844 | $1.4M |
| 14 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $1.4M |
| 15 | 1154372340 | $1.3M |
| 16 | Hartford Hospital Hartford, CT · General Acute Care Hospital | $1.3M |
| 17 | 1538328232 | $1.3M |
| 18 | 1083925168 | $1.3M |
| 19 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $1.2M |
| 20 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $1.2M |
Showing top 20 of 2K providers billing this code