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CPT 94680 Fee Schedule

Last Verified: February 2026

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.

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Key FactDetail
Service Type

Medicine Services and Procedures

Pulmonary Procedures

Common Place of Service

11 - Office

22 - On Campus Outpatient Hospital

21 - Inpatient Hospital

Common Modifiers

None

26 - Professional component

59 - Distinct Procedural Service

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 94680

National average reimbursement for CPT 94680 by major payers:

bcbs

$69.38

uhc

$74.26

aetna

$69.92

cigna

$91.42

Preview provider-level rates for...
For billing codeCPT 94680
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 94680

United
94680$56.721255478004 - CHRISTOPHER RAIO112050523 - ST FRANCIS HOSPITALNYEmergency Medicine Physician (207P00000X)
United
94680$118.621417900168 - SUNILA OCONNOR363279680 - (IL) PEDIATRIC FACULTY FOUNDATION INILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
94680$24.021548279870 - VINOD ALLURI364015560 - LOYOLA UNIVERSITY MEDICAL CENTERTXPsychiatry Physician (2084P0800X)
United
94680$55.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
94680$92.491851768337 - KELLY RIDGES362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C.ILFamily Nurse Practitioner (363LF0000X)
United
94680$55.001588756076 - ALL WAYS HOMECARE INC202696236FLHome Health Agency (251E00000X)
United
94680$144.351295791812 - LEON EPSTEIN363279680 - (IL) PEDIATRIC FACULTY FOUNDATION INILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
94680$85.231609823194 - SACRED HEART HEALTH SYSTEM INC, SACRED HEART HOME CARE590634434 - SACRED HEART HEALTH SYSTEM INCFLHome Health Agency (251E00000X)
United
94680$75.121144203753 - HAIDAR KABBANI911780160ILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
94680$24.441407807746 - SYED KHAN364015560 - LOYOLA UNIVERSITY MEDICAL CENTERILPsychiatry Physician (2084P0800X)
United
94680$20.751255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
94680$14.641215597554 - MATTEO RESPINO351747218 - INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INCILPsychiatry Physician (2084P0800X)
United
94680$27.481467802108 - MIRIAM BALTUANO SONGHURST863284696 - OU HEALTH PARTNERS INCOKNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
94680$118.621225211600 - JOHN MILLICHAP363279680 - (IL) PEDIATRIC FACULTY FOUNDATION INCONeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
94680$30.671003166612 - MATTHEW LILLEY931261079 - THE ORTHOPEDIC AND NEUROSURGICAL CENTER OF THE CASCADESOROrthopaedic Surgery Physician (207X00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 94680 vs. Other Pulmonary Procedures Codes

The CPT 94680 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 94680 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.

CodeComplexityDescription
94060-CPTLowBronchospasm Evaluation: Spirometry As In 94010 Before And After Bronchodilator (Aerosol Or Parenteral)
94070-CPTLowProlonged Postexposure Evaluation Of Bronchospasm With Multiple Spirometric Determinations After Antigen Cold Air Methacholine Or Other Chemical Agent With Subsequent Spirometrics
94662-CPTLowContinuous Negative Pressure Ventilation
94680-CPTLowOxygn Uptke,Expir.Gas Anal;Dir,Smpl

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94680. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 94680 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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