Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 94680 Fee Schedule
Last Verified: October 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.
Test For Oxygen Use, Lung Function Test That Measures The Amount Of Oxygen Absorbed Into The Blood. It Analyzes The Amount Of Oxygen In Exhaled Air To Learn How Much Oxygen The Body Is Using.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Pulmonary Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $57.78 national non-facility rate (2026) · View Medicare rates for 94680 |
| Medicaid Fee Schedule | $47.03 median of the 8 states in the free preview · View Medicaid rates for 94680 |
National average reimbursement for CPT 94680 by major payers:
$69.38
$74.26
$69.92
$88.74
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 94680.
CPT 94680
5 of 25 sample ratesHigher to lower in this preview
Leon Epstein
Pediatric Faculty Foundation In
$144.35Published rateSacred Heart Health System Inc, Sacred Heart Home Care
Sacred Heart Health System Inc
$85.23Published rateAbdullah Bin Mahfodh
Community Home Physicians LLC D/B/A Community Physicians
$60.65Published rateMiriam Baltuano Songhurst
Ou Health Partners Inc
$27.48Published rateMatteo Respino
Indiana University Health Care Associates Inc
$14.64Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 94060-CPT | Low | Breathing Test With Medication, Test To See How Well A Medication For Increasing Airflow To The Lungs (Bronchodilator) Works. The Person Breathes Into A Spirometer (Device For Measuring Airflow) Before Using The Medicine And Then Afterward. |
| 94680-CPT | Low | Test For Oxygen Use, Lung Function Test That Measures The Amount Of Oxygen Absorbed Into The Blood. It Analyzes The Amount Of Oxygen In Exhaled Air To Learn How Much Oxygen The Body Is Using. |
| 94681-CPT | Low | Test For Oxygen Use, Lung Function Test That Measures The Amount Of Oxygen Absorbed Into The Blood. It Analyzes The Amount Of Oxygen In Exhaled Air To Learn How Much Oxygen The Body Is Using. |
| 94690-CPT | Low | Test For Oxygen Use, Lung Function Test That Measures The Amount Of Oxygen Absorbed Into The Blood. It Analyzes The Amount Of Oxygen In Exhaled Air To Learn How Much Oxygen The Body Is Using. |
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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 94680) and we'll show you how you compare in 15 minutes or less.