CPT 94617 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Pulmonary Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 94617 |
National average reimbursement for CPT 94617 by major payers:
$111.66
$120.81
$114.88
$157.50
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 94617 | ||||||
United | 94617 | $61.91 | 1689166027 - ANIRUDDHA DEKA | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 94617 | $41.91 | 1013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 94617 | $59.84 | 1730214206 - KALYANI GAVINI | 371158318 - (IL) SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94617 | $116.04 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 94617 | $156.72 | 1508986308 - COREY GOLDSTEIN | 911779996 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 94617 | $111.52 | 1033347125 - DAVID HANRAHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MN | Psychiatry Physician (2084P0800X) |
United | 94617 | $56.06 | 1306474986 - MELVIN JOSEPH | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 94617 | $63.54 | 1851376230 - ANITA PAIRITZ | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IN | Psychiatry Physician (2084P0800X) |
United | 94617 | $101.51 | 1225211600 - JOHN MILLICHAP | 753186720 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94617 | $176.17 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 94617 | $77.93 | 1710275110 - PRAVESH DEOTALE | 430654872 - ST LOUIS UNIVERSITY | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94617 | $111.52 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 94617 | $173.14 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 94617 | $86.04 | 1962507954 - ROSELIN ARUNACHALAM | 371140016 - CARLE HEALTH CARE INCORPORATED | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94617 | $334.89 | 1386969079 - ADAM WALLACE | 391678306 - AURORA MEDICAL GROUP INC | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 94617 vs. Other Pulmonary Procedures Codes
The CPT 94617 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 94617 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 |
|---|---|---|
| 94012-CPT | Low | Measurement Of Spirometric Forced Expiratory Flows, Before And After Bronchodilator, In An Infant Or Child Through 2 Years Of Age |
| 94013-CPT | Low | Measurement Of Lung Volumes (Ie Functional Residual Capacity [Frc] Forced Vital Capacity [Fvc] And Expiratory Reserve Volume [Erv] In An Infant Or Child Through 2 Years Of Age |
| 94610-CPT | Low | Intrapulmonary Surfactant Administration By A Physician Or Other Qualified Health Care Professional Through Endotracheal Tube (Revised 01/01/13) |
| 94617-CPT | Low | Exercise Test For Bronchospasm Including Pre- And Post-Spirometry And Pulse Oximetry; With Electrocardiographic Recording(S) (Desc Rvsd 1/1/21) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94617. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94617 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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