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See a sample rate comparisonCPT 94010 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Spirometry Including Graphic, Spirometry Including Graphic Record Total And Timed Vital Capacity Expiratory Flow Rate Measurement(S) With Or Without Maximal Voluntary Ventilation
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Pulmonary Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $29.73 national non-facility rate (2026) · View Medicare rates for 94010 |
| Medicaid Fee Schedule | $24.325 median of the 8 states in the free preview · View Medicaid rates for 94010 |
National average reimbursement for CPT 94010 by major payers:
$35.31
$44.39
$42.54
$49.79
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CPT 94010
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$92.16Published rateSheng Ye
Harvey R Gross Md PC
$32.20Published rateAlexey Volokhov
Harvey R Gross Md PC
$23.11Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$12.33Published rateLeslie Sojka
Leslie Sojka Md PA
$6.21Published rate
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See a sample payer proposalCPT 94010 vs. Other Pulmonary Procedures Codes
The CPT 94010 code is part of the Medicine Services and Procedures services used for Pulmonary Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 94010 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 94002-CPT | Low | Ventilation Assist And Managem, Ventilation Assist And Management Initiation Of Pressure Or Volume Preset Ventilators For Assisted Or Controlled Breathing Hospital Inpatientobservation Initial Day |
| 94010-CPT | Low | Spirometry Including Graphic, Spirometry Including Graphic Record Total And Timed Vital Capacity Expiratory Flow Rate Measurement(S) With Or Without Maximal Voluntary Ventilation |
| 94011-CPT | Low | Spirometer Breath Test, This Test Involves Breathing Out Hard Into A Spirometer (Device For Measuring Airflow). The Spirometer Records The Amount And Rate Of Airflow. |
| 94060-CPT | Low | Breathing Test With Medication, Test To See How Well A Medication For Increasing Airflow To The Lungs (Bronchodilator) Works. The Person Breathes Into A Spirometer (Device For Measuring Airflow) Before Using The Medicine And Then Afterward. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94010 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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