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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Pulmonary Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | 59 - Distinct Procedural Service U7 |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 94150 |
| Medicaid Fee Schedule | $15.66 median of the 8 states in the free preview · View Medicaid rates for 94150 |
National average reimbursement for CPT 94150 by major payers:

$31.55

$31.07

$30.22

$39.02
Choose a payer to see a sample of rates for CPT 94150.
Andrew Knox
Aurora Medical Group Inc
Joseph Pepitone
Northshore University Healthsystem Faculty Practice Associates
Adult And Pediatric Neurology
Omotola Ajibade
Loyola University Medical Center
Kerry Cook
Town Center Orthopaedic Associates, P.C.
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 94150 vs. Other Pulmonary Procedures Codes
The CPT 94150 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 94150 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 |
|---|---|---|
| 94150-CPT | Low | Test Amount Of Air Exhaled, Test To Measure Maximum Amount Of Air That Can Be Breathed Out. |
| 94200-CPT | Low | Lung Function Test, A Lung Function Test Evaluates Breathing Ability. Measures Include The Amount Of Air Entering Or Leaving The Body The Amount Of Oxygen Circulating To Organs And The Amount Of Air Left In The Lungs After Exhaling. |
| 94375-CPT | Low | Test Change In Lung Volume, Measurement Of The Changes In Lung Volume Over Time As During A Series Of Tests. The Curve Described By The Values Can Help To Locate The Exact Place Where Airflow Is Restricted. |
| 94450-CPT | Low | Breathing Response To Hypoxia |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94150. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94150 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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