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See a sample rate comparisonCPT 94760 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Pulmonary Procedures |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | 59 - Distinct Procedural Service HH |
| Complexity Level | Low |
| Medicare Fee Schedule | $4.01 national non-facility rate (2026) · View Medicare rates for 94760 |
| Medicaid Fee Schedule | $3.10 median of the 8 states in the free preview · View Medicaid rates for 94760 |
National average reimbursement for CPT 94760 by major payers:
$3.56
$3.52
$3.82
$5.36
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CPT 94760
5 of 25 sample ratesHigher to lower in this preview
Aaron Askew
Praxis Health, P.C.
$23.80Published rateCharles Marcuccilli
$5.07Published rateJanice Kowalski
Edward Health Ventures
$4.86Published rateColleen Buhrfiend
Veterans Assistance Commission C
$3.93Published rateMelissa Wagner-Schuman
$2.24Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 94760 vs. Other Pulmonary Procedures Codes
The CPT 94760 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 94760 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 |
|---|---|---|
| 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. |
| 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. |
| 94761-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. |
| 94762-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 94760. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94760 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians, hospitals, and other healthcare providers to describe the services and procedures they perform. These codes are essential for accurate medical billing and processing of insurance claims.
An Explanation of Benefits (EOB) is a document sent by your health insurance company after you receive medical care. It explains what medical services were covered, how much the insurer paid, and what amount you are responsible for. An EOB is not a bill, but it details how your bill will be calculated based on your insurance plan.
A deductible is the amount of money you must pay out of your own pocket for covered healthcare services before your health insurance plan begins to pay. For example, if your deductible is $1,000, you are responsible for paying the first $1,000 of covered medical expenses each year before your insurer starts to contribute.
A copayment (or copay) is a fixed amount you pay for a covered healthcare service after you've paid your deductible (if applicable). For example, you might have a $20 copay for a doctor's visit or a $50 copay for an emergency room visit. This amount usually doesn't count towards your deductible but does count towards your out-of-pocket maximum.
Coinsurance is your share of the cost of a healthcare service, calculated as a percentage of the allowed amount for the service, after you've met your deductible. For example, if your plan has an 80/20 coinsurance, your insurance pays 80% and you pay 20% of the cost for covered services after your deductible is met.
To get an estimate for the cost of a medical procedure or service, you can contact your healthcare provider's billing department or your insurance company directly. For a more comprehensive search based on specific CPT codes and your location, you can use tools like Payerprice's fee schedule lookup tool. This tool allows users to search for prices with CPT codes and specific location details, providing a clearer picture of potential costs before treatment.
Medical costs can vary significantly due to several factors, including the provider's location, the specific facility (e.g., hospital vs. outpatient clinic), the complexity of the procedure, the type of insurance plan, and negotiated rates between providers and insurers. Even for the same service, prices can differ widely based on these variables.
If you receive a medical bill you don't understand, first review your Explanation of Benefits (EOB) from your insurance company to compare it with the bill. Then, contact your healthcare provider's billing department to ask for clarification. If you still have questions or believe there's an error, contact your health insurance company. For information on potential charges based on CPT codes, you can also utilize Payerprice's fee schedule lookup tool to research typical costs in your area.