G47.33: Obstructive sleep apnea (adult) (pediatric)
G47.33, obstructive sleep apnea (adult) (pediatric), is listed as a covered diagnosis in 17 Medicare billing and coding articles that apply to 46 HCPCS Level II codes, including G0399 (Home sleep test (hst) with type iii portable monitor…), G0400 (Home sleep test (hst) with type iv portable monitor…), G0398 (Home sleep study test (hst) with type ii portable monitor…). 8 of these codes have a 2026 DMEPOS fee schedule amount; E0471 pays $324.35 to $642.07 (RR) depending on the state. The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with G47.33 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | Carrier judgment | — | 6 |
| G0400 | Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels | Carrier judgment | — | 6 |
| G0398 | Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation | Carrier judgment | — | 6 |
| E0471 | Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | Special coverage instructions apply | $324.35–$642.07 (RR) | 1 |
| E0470 | Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | Special coverage instructions apply | $129.84–$237.27 (RR) | 1 |
| A7027 | Combination oral/nasal mask, used with continuous positive airway pressure device, each | Carrier judgment | $142.24–$218.86 (NU) | 1 |
| E0601 | Continuous positive airway pressure (CPAP) device | Special coverage instructions apply | $50.04–$100.22 (RR) | 1 |
| A4604 | Tubing with integrated heating element for use with positive airway pressure device | Carrier judgment | $49.31–$76.79 (NU) | 1 |
| A7031 | Face mask interface, replacement for full face mask, each | Carrier judgment | $41.70–$74.80 (NU) | 1 |
| A7032 | Cushion for use on nasal mask interface, replacement only, each | Carrier judgment | $23.09–$42.96 (NU) | 1 |
| A7033 | Pillow for use on nasal cannula type interface, replacement only, pair | Carrier judgment | $19.26–$31.66 (NU) | 1 |
| E1399 | Durable medical equipment, miscellaneous | Carrier judgment | — | 1 |
| E0486 | Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment | Carrier judgment | — | 1 |
| E0485 | Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment | Carrier judgment | — | 1 |
| C8007 | Open implantation of hypoglossal nerve neurostimulator array and pulse generator, not requiring insertion of a separate distal respiratory sensor electrode or electrode array | Carrier judgment | — | 3 |
| C8008 | Revision or replacement of hypoglossal nerve neurostimulator array including connection to existing pulse generator | Carrier judgment | — | 3 |
| C8009 | Removal of hypoglossal nerve neurostimulator array and pulse generator | Carrier judgment | — | 3 |
| C9727 | Insertion of implants into the soft palate; minimum of three implants | Special coverage instructions apply | — | 1 |
| G0238 | Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0237 | Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring) | Carrier judgment | — | 2 |
| G0239 | Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring) | Carrier judgment | — | 2 |
| J2785 | Injection, regadenoson, 0.1 mg | Carrier judgment | — | 2 |
| J0461 | Injection, atropine sulfate, 0.01 mg | Special coverage instructions apply | — | 2 |
| J0153 | Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds) | Special coverage instructions apply | — | 2 |
| Q9957 | Injection, perflutren lipid microspheres, per ml | Carrier judgment | — | 2 |
21 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing G47.33
- A52467: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 11 Level II codes). LCD with the same title: L33718
- A52512: Oral Appliances for Obstructive Sleep Apnea - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 3 Level II codes). LCD with the same title: L33611
- A56905: Billing and Coding: Surgical Treatment of Obstructive Sleep Apnea (OSA) (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34526
- A57948: Billing and Coding: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L38307, L38310, L38385, L38387
- A57944: Billing and Coding: Hypoglossal Nerve Stimulation for Treatment of Obstructive Sleep Apnea (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes)
- A58075: Billing and Coding: Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (Palmetto GBA (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L38276
- A57049: Billing and Coding: Polysomnography and Other Sleep Studies (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L36839, L36861, L36902
- A57697: Billing and Coding: Polysomnography and Other Sleep Studies (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L36839, L36861, L36902
- A56903: Billing and Coding: Polysomnography and Other Sleep Studies (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L36839, L36861, L36902
- A56995: Billing and Coding: Polysomnography (Palmetto GBA (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L36593
- A57496: Billing and Coding: Polysomnography and Sleep Testing (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L33405
- A56923: Billing and Coding: Outpatient Sleep Studies (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L35050
- A56717: Billing and Coding: Respiratory Therapy (Respiratory Care) (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34430
- A57224: Billing and Coding: Respiratory Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 3 Level II codes). LCD with the same title: L34149
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 19 Level II codes). LCD with the same title: L33577, L34338
2 more articles list G47.33.
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other G47 diagnoses (Sleep disorders)
- G47.30 — Sleep apnea, unspecified
- G47.31 — Primary central sleep apnea
- G47.32 — High altitude periodic breathing
- G47.34 — Idiopathic sleep related nonobstructive alveolar hypoventilation
- G47.35 — Congenital central alveolar hypoventilation syndrome
- G47.36 — Sleep related hypoventilation in conditions classified elsewhere
- G47.37 — Central sleep apnea in conditions classified elsewhere
- G47.39 — Other sleep apnea
- G47.10 — Hypersomnia, unspecified
- G47.11 — Idiopathic hypersomnia with long sleep time
- G47.12 — Idiopathic hypersomnia without long sleep time
- G47.13 — Recurrent hypersomnia
- G47.14 — Hypersomnia due to medical condition
- G47.19 — Other hypersomnia
- G47.411 — Narcolepsy with cataplexy
- G47.419 — Narcolepsy without cataplexy
- G47.421 — Narcolepsy in conditions classified elsewhere with cataplexy
- G47.429 — Narcolepsy in conditions classified elsewhere without cataplexy
- G47.50 — Parasomnia, unspecified
- G47.51 — Confusional arousals
- G47.52 — REM sleep behavior disorder
- G47.53 — Recurrent isolated sleep paralysis
- G47.54 — Parasomnia in conditions classified elsewhere
- G47.59 — Other parasomnia
- G47.61 — Periodic limb movement disorder
- G47.8 — Other sleep disorders
- G47.9 — Sleep disorder, unspecified
Frequently asked questions
Does Medicare cover G47.33 (Obstructive sleep apnea (adult) (pediatric))?
Medicare covers items and services, not diagnoses. 17 Medicare billing and coding articles list G47.33 as a covered diagnosis for 46 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 G47.33?
The Level II codes from the policies most specific to this diagnosis are G0399 (Home sleep test (hst) with type iii portable monitor…, 6 articles); G0400 (Home sleep test (hst) with type iv portable monitor…, 6 articles); G0398 (Home sleep study test (hst) with type ii portable monitor…, 6 articles); E0471 (Respiratory assist device, bi-level pressure capability…, 1 article); E0470 (Respiratory assist device, bi-level pressure capability…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with G47.33?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0471 $324.35 to $642.07 (RR); E0470 $129.84 to $237.27 (RR); A7027 $142.24 to $218.86 (NU); E0601 $50.04 to $100.22 (RR). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list G47.33?
A52467 (Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea - Policy Article); A52512 (Oral Appliances for Obstructive Sleep Apnea - Policy Article); A56905 (Billing and Coding: Surgical Treatment of Obstructive Sleep Apnea (OSA)), and 14 more articles.
What is ICD-10-CM code G47.33?
G47.33 is the ICD-10-CM code for obstructive sleep apnea (adult) (pediatric), in category G47 (Sleep disorders), chapter 6: Diseases of the nervous system.
Next steps
- Run a reimbursement report for a device billed under G0399
- Watch G0399 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0399
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 6: Diseases of the nervous system · All diagnoses · HCPCS lookup