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See a sample rate comparisonCPT 94375 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Pulmonary Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $42.09 national non-facility rate (2026) · View Medicare rates for 94375 |
| Medicaid Fee Schedule | $33.995 median of the 8 states in the free preview · View Medicaid rates for 94375 |
National average reimbursement for CPT 94375 by major payers:
$47.39
$49.32
$51.00
$61.49
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CPT 94375
5 of 25 sample ratesHigher to lower in this preview
Angela Chang
$176.91Published rateAlan Goldsobel
$41.72Published rateAngelos Koutsonikolis
Angelos Koutsonikolis Md PA
$23.81Published rateJames Kidd
$18.40Published rateJennifer Xu
Capital Allergy & Respiratory Disease Center A Medical Corporation
$13.97Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 94375 vs. Other Pulmonary Procedures Codes
The CPT 94375 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 94375 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. |
| 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 |
| 94644-CPT | Low | Conti Nhalation Treatmn W/ Aerosol Medicat For Acute Airw, Continuous Inhalation Treatment With Aerosol Medication For Acute Airw |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94375. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94375 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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