CPT 94618 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 • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 94618 by major payers:
$42.29
$44.18
$45.75
$63.68
| 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 94618 | ||||||
United | 94618 | $20.95 | 1922115914 - MEMORIAL HEALTH SYSTEMS INC, ADVENTHEALTH MEDICAL GROUP | 590973502 - MEMORIAL HEALTH SYSTEMS INC | FL | Surgery Physician (208600000X) |
United | 94618 | $33.86 | 1710977251 - FLORIDA SURGICAL GROUP, P.A. | 591713370 - (FL) FLORIDA SURGICAL GROUP PA | FL | Surgery Physician (208600000X) |
United | 94618 | $26.96 | 1992233936 - DIANA LANE | 921079806 - (FL) BODY BY BARIATRICS LLC | FL | Surgery Physician (208600000X) |
United | 94618 | $43.09 | 1013975192 - WILLIAM HUETHER | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 94618 | $15.65 | 1801162094 - BERTHA BAUM | 650932856 - (FL) ARTHUR S. COLSKY, M.D., PH.D., P.A. D/B/A SKIN CEN | FL | Dermatology Physician (207N00000X) |
United | 94618 | $12.86 | 1730441841 - AARON BRAFMAN | 592485899 | FL | Urology Physician (208800000X) |
United | 94618 | $25.62 | 1154815546 - FOREFRONT DERMATOLOGY, S.C., ADVANCED DERMATOLOGY & SKIN CARE CENTRE | 391351587 - FOREFRONT DERMATOLOGY, S.C. | FL | Dermatology Physician (207N00000X) |
United | 94618 | $15.65 | 1336584960 - DEVORAH SHAGALOV | 882549816 - (FL) SHAGALOV DERMATOLOGY PA | FL | Dermatology Physician (207N00000X) |
United | 94618 | $31.35 | 1649619115 - EMILIO ALONSO | 421748185 - (FL) OSCEOLA SURGICAL ASSOCIATES LLC | FL | Surgery Physician (208600000X) |
United | 94618 | $15.57 | 1164604005 - TOBIAS CARLING | 383669433 - (FL) NORMAN PARATHYROID CENTER PA | FL | Surgery Physician (208600000X) |
United | 94618 | $70.61 | 1548228133 - DAVID JOHNSTON | 593366100 - NORTH FLORIDA SURGEONS, P.A. | FL | Surgery Physician (208600000X) |
United | 94618 | $9.44 | 1841336310 - DANY OBEID | 825486007 - (FL) EXCELLENCE HEALTH LLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 94618 | $41.63 | 1801183934 - FRANCISCO DE JESUS PAULINO | 262909414 - MILLENNIUM PHYSICIAN GROUP, LLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 94618 | $29.10 | 1558371088 - ALLAN GOLDMAN | 237313346 - UNIVERSITY MEDICAL SERVICE ASSOCIATION INC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 94618 | $25.62 | 1366965857 - FAWAZ MAKKI | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Otolaryngology Physician (207Y00000X) |
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 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 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) |
| 94618-CPT | Low | Pulmonary Stress Testing (Eg, 6-Minute Walk Test), Including Measurement Of Heart Rate, Oximetry, And Oxygen Titration, When Performed |
| 94619-CPT | Low | "Exercise Test For Bronchospasm, Including Pre- And Post-Spirometry And Pulse Oximetry; Without Electrocardiographic Recording(S)" |
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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