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See a sample rate comparisonCPT 94681 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 |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $50.10 national non-facility rate (2026) · View Medicare rates for 94681 |
| Medicaid Fee Schedule | $42.68 median of the 8 states in the free preview · View Medicaid rates for 94681 |
National average reimbursement for CPT 94681 by major payers:
$63.02
$76.67
$69.80
$87.86
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CPT 94681
5 of 25 sample ratesHigher to lower in this preview
Meghan O'Neill
Pediatric Faculty Foundation In
$124.50Published rateMark Alter
$83.50Published rateShahzaib Khan
Advocate Health And Hospitals Corporation
$70.95Published rateClaudine Sinsioco
Inova Health Care Services
$21.20Published ratePravesh Deotale
St Louis University
$14.11Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 94681 vs. Other Pulmonary Procedures Codes
The CPT 94681 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 94681 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 |
|---|---|---|
| 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. |
| 94760-CPT | Low | Blood Oxygen Level Check, A Small Monitor That Checks The Amount Of Oxygen In The Blood Is Clipped To A Persons Ear Or Fingertip. A Single Test May Be Done Or Levels May Be Monitored Over Time. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94681. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94681 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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