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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 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $37.08 national non-facility rate (2026) · View Medicare rates for 94618 |
| Medicaid Fee Schedule | $30.015 median of the 8 states in the free preview · View Medicaid rates for 94618 |
National average reimbursement for CPT 94618 by major payers:

$42.29

$44.18

$45.75

$62.23
Choose a payer to see a sample of rates for CPT 94618.
Amanda Kovacich
Moses Cone Medical Services Inc
Florida Surgical Group, P.A.
Florida Surgical Group PA
Kendall Adkisson
Naples Center For Dermatology And Cosmetic Surgery
Devorah Shagalov
Shagalov Dermatology PA
Dany Obeid
Excellence Health LLC
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Rate Benchmarking
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Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 94618 vs. Other Pulmonary Procedures Codes
The CPT 94618 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 94618 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 |
|---|---|---|
| 94610-CPT | Low | Intrapulmonary Surfactant Admi, Intrapulmonary Surfactant Administration By A Physician Or Other Qualified Health Care Professional Through Endotracheal Tube |
| 94617-CPT | Low | Exercise Test For Bronchospasm, Exercise Test For Bronchospasm Including Pre- Andpost-Spirometry Electrocardiographic Recording(S ) And Pulse Oximetry Age Adjustment (As Needed) And Scheduling Of Additional Test(S) When Performed |
| 94618-CPT | Low | Pulmonary Stress Testing (Eg, Pulmonary Stress Testing (Eg 6-Minute Walk Test)Including Measurement Of Heart Rate Oximetry An D Oxygen Titration When Performed Age Adjustment (As Needed) And Scheduling Of Additional Test(S) When Performed |
| 94619-CPT | Low | Exercise Test For Bronchospasm, The Test Measures The Amount Of Air That Moves In And Out Of The Lungs During Breathing. Exercise Is Introduced To See If A Bronchospasm (Asthma Attack) Occurs. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94618. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94618 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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