Reimbursement Codes

CPT Codes

The following suggested use of CPT codes is only provided as a suggestion and is in no way an official recommendation or guideline. Charges vary widely across the nation.*
The following list is a range of CPT codes with reimbursement fees from published information from the Medicare allowables Unadjusted 2002.**

* Most commonly used CPT codes for Spirometry. Additional Codes may be found in the current issue of “Current Procedural Terminology” (CPT) Manual, Published by the American Medical Association. All Spirometers may not perform all procedures identified or listed with CPT Codes.

** Actual Medicare and Medicaid allowables vary by geographic region. Contact your regional provider for specific coverage and allowables.

94010 Spirometry Complete

Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation (MVV).

National Average: $36.09

94060 Bronchodilation Responsiveness

Spirometry, often referred to as pre/post spirometry, before and after a bronchodilator (aerosol) for the purpose of bronchospasm evaluation. This procedure is the same as 94010 with the addition of nebulizer treatment delivering a bronchodilator and subsequent repeat of spirometry to measure the efficacy of treatment. Post spirometry should be performed at least 10 minutes after nebulizer treatment is completed to give bronchodilator time to reach maximum effectiveness.

National Average: $65.00

94375 Respiratory Flow Volume Loop

Respiratory Flow Volume Loop, includes expiratory and inspiratory portion of loop. Cannot be billed at the same visit as 94010 or 94060 or 94070

National Average: $39.70

A4614 Peak Flow Meters

All-FLOW Peak Flow Meters, Airzone Peak Flow Meter, Mini-Wright Standard or AFS Peak Flow Meters, Private and Medicaid: S8096, Physician Service: S8110

National Average: $ 21.95

A4627 Valve Holding Chambers

Valve Holding Chambers, Private and Medicaid, S8100 – Chamber no mask, S8101 – Chamber with mask

94620 Simple Pulmonary Stress Test

Simple Pulmonary Stress Test is often referred to as the 6-minute walk. Measurements of blood pressure, respiratory rate, heart rate, oxygen saturation level (%), exertion scale measurement, and the distance performed before and after walking the patient for 6 minutes.

National Average: $120.00

94660 CPAP

CPAP, Continuous Positive Airway Pressure, initiation and management.

National Average: $52.00

94664 Training

Training

National Average: $18.00

94760 Oximetry, single determination

Oximetry, single determination, often referred to as a spot check is performed with patient in a sitting position.

National Average: $9.00

94761 Oximetry, multiple determination

Oximetry, multiple determination, for the purpose of evaluating the patient while sitting, standing, and during exercise or exertion.

National Average: $24.00

94762 Oximetry, continuous overnight monitoring

Oximetry, continuous overnight monitoring, for the purpose of determining oxygen saturation levels and heart rate patterns during the hours of sleep..

National Average: $40.00

94770 Carbon dioxide

Carbon dioxide, expired gas determination by infrared analyzer