CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Sleep medicine
95811 — Polysomnography; age 6 or older, sleep staging with 4 or more additional parameters, with CPAP or bilevel ventilation initiation, attended by technologist
This is an in-lab overnight sleep study that includes titrating (adjusting) a CPAP or bilevel PAP machine to find the right pressure for your sleep apnea.
- Typical setting: Sleep lab, home
- National avg charge (illustrative): $1,000–$4,000 (similar range to 95810; may be slightly higher due to CPAP equipment use)
- Most-disputed reason: Billing 95811 for a home CPAP setup appointment — this code requires an attended, overnight, in-lab polysomnography study.
What it means
What 95811 actually means
This is an in-lab overnight sleep study that includes titrating (adjusting) a CPAP or bilevel PAP machine to find the right pressure for your sleep apnea. A technologist is present throughout the night to monitor both your sleep patterns and your response to the device.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 95811 for a home CPAP setup appointment — this code requires an attended, overnight, in-lab polysomnography study.
- Billing both 95810 and 95811 for the same night without a documented split-night protocol where at least 2 hours of diagnostic recording preceded the CPAP titration portion.
- Charges for CPAP supplies or DME (durable medical equipment) being bundled into the 95811 claim — equipment is separately billable under HCPCS E-codes.
If you see 95811 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 95811 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 95811 on a bill.
95811 FAQ
Plain-English answers.
What does 95811 usually cost?
$1,000–$4,000 (similar range to 95810; may be slightly higher due to CPAP equipment use). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 95811?
Billing 95811 for a home CPAP setup appointment — this code requires an attended, overnight, in-lab polysomnography study.
What should I do if I see 95811 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 95811 before paying.
Don't pay 95811 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.