CPT 94619 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 • 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
National average reimbursement for CPT 94619 by major payers:
$84.46
$98.40
$89.56
$123.01
| 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 94619 | ||||||
United | 94619 | $180.63 | 1790936540 - SRISHTI NANGIA | 131623978 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $76.76 | 1679739395 - BETSY OSTRANDER | 942854057 - IHC HEALTH SERVICES INC | UT | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94619 | $114.48 | 1881012235 - LAUREN PREST | 910843135 | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $39.49 | 1134741028 - SHAHZAIB KHAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $536.29 | 1760502058 - P. DANIEL LE GRANGE | 943281657 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94619 | $122.37 | 1679968697 - JEREMIAH BREWER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 94619 | $141.33 | 1932130325 - ELIZABETH BERRY-KRAVIS | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $61.47 | 1437438249 - KAPIL AEDMA | 370661223 - METHODIST MEDICAL CENTER OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94619 | $79.80 | 1205125473 - KELLEY VOLPE | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $92.87 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | VA | Psychiatry Physician (2084P0800X) |
United | 94619 | $69.16 | 1265883375 - JOCELYN LORENZO | 726000821 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $88.48 | 1992961643 - CYNTHIA GORDON | 815174138 - (IL) ILLINOIS PROFESSIONALS HEALTH PROGR | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $100.29 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 94619 | $160.44 | 1386755486 - DOUGLAS NORDLI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $125.12 | 1205213261 - TAMAR CACERES | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurodevelopmental Disabilities Physician (2084P0005X) |
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 94619 vs. Other Pulmonary Procedures Codes
The CPT 94619 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 94619 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 |
| 94617-CPT | Low | Exercise Test For Bronchospasm Including Pre- And Post-Spirometry And Pulse Oximetry; With Electrocardiographic Recording(S) (Desc Rvsd 1/1/21) |
| 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 94619. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94619 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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