CPT 94667 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 • 20 - Urgent Care Facility |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 94667 |
National average reimbursement for CPT 94667 by major payers:
$33.98
$31.00
$29.29
$39.93
| 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 94667 | ||||||
United | 94667 | $48.54 | 1033347125 - DAVID HANRAHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | VA | Psychiatry Physician (2084P0800X) |
United | 94667 | $46.93 | 1174859284 - MATTHEW NIEDZWIECKI | 811324691 | IL | Psychiatry Physician (2084P0800X) |
United | 94667 | $42.61 | 1780633271 - SHANNON SHI | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94667 | $35.81 | 1972543080 - HOSSAM ABDELSALAM | 363978153 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94667 | $32.24 | 1932272952 - MOHAMMED HOMSI | 452353153 - (IL) HOMSI PEDIATRIC NEUROLOGY INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94667 | $27.18 | 1073530523 - DAVID KIM | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Interventional Pain Medicine Physician (208VP0014X) |
United | 94667 | $37.40 | 1235186297 - MARY DOBBINS | 376005961 - (IL) BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94667 | $43.63 | 1942650130 - MALIK NASSAN | 362679194 - (IL) HEAD & NECK AND COSMETIC SURGERY ASSOCIATES, LLC | IL | Psychiatry Physician (2084P0800X) |
United | 94667 | $24.87 | 1912620980 - NIDHI MEHTA | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 94667 | $42.09 | 1669678009 - NADIA MIRZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 94667 | $47.70 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 94667 | $48.54 | 1033347125 - DAVID HANRAHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 94667 | $27.18 | 1386721033 - JOHN BUTTARI | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 94667 | $44.86 | 1063520781 - ELLIOT GERSHON | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 94667 | $47.70 | 1760412621 - RHONDA LAMPEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
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 94667 vs. Other Pulmonary Procedures Codes
The CPT 94667 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 94667 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 |
|---|---|---|
| 94375-CPT | Low | Respiratory Flow Volume Loop |
| 94450-CPT | Low | Breathing Response To Hypoxia |
| 94664-CPT | Low | Demonstration And/Or Evaluation Of Patient Utilization Of An Aerosol Generator Nebulizer Metered Dose Inhaler Or Ippb Device (Desc Rev 01/01/03) Ation |
| 94667-CPT | Low | Manipulation Chest Wall, Such As Cupping, Percussing, And Vibration To Facilitate Lung Function; Initial Demonstration And/Or Evaluation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94667. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94667 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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