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See a sample rate comparisonCPT 94727 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.
Gas Dilution Or Washout For De, Gas Dilution Or Washout For Determination Of Lung Volumes And When Performed Distribution Of Ventilation And Closing Volumes
| 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 | $49.77 national non-facility rate (2026) · View Medicare rates for 94727 |
| Medicaid Fee Schedule | $40.51 median of the 8 states in the free preview · View Medicaid rates for 94727 |
National average reimbursement for CPT 94727 by major payers:
$53.91
$56.54
$58.00
$79.09
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CPT 94727
5 of 25 sample ratesHigher to lower in this preview
P. Daniel Le Grange
$206.53Published rateHaidar Kabbani
Pediatric Faculty Foundation In
$60.61Published rateMarcus Byrd
New York City Health And Hospitals Corporation
$48.00Published rateCharles Marcuccilli
Pediatric Faculty Foundation In
$29.92Published rateRegina Hall-Ngorima
Veterans Assistance Commission C
$14.35Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 94727 vs. Other Pulmonary Procedures Codes
The CPT 94727 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 94727 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 |
|---|---|---|
| 94726-CPT | Low | Whole-Body Air Volume Test, An Air Volume Test Measures Changes In The Amount Of Air Circulating In The Body While A Person Breathes. A Whole-Body Test Is Done In A Pressurized Room. The Test Is Called Plethysmography. |
| 94727-CPT | Low | Gas Dilution Or Washout For De, Gas Dilution Or Washout For Determination Of Lung Volumes And When Performed Distribution Of Ventilation And Closing Volumes |
| 94728-CPT | Low | Airway Resistance Test, A Measure Of Airway Resistance (Ability Of Air To Flow Through). |
| 94729-CPT | Low | Gas Transfer Ability Test, A Test Of The Ability Of The Lung To Move Gases Through Its Tissues (Transfer). The Test Uses A Small Amount Of Carbon Monoxide. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94727. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94727 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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