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See a sample rate comparisonCPT 94761 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 20 - Urgent Care Facility |
| Common Modifiers | 59 - Distinct Procedural Service 76 - Repeat procedure by same physician |
| Complexity Level | Low |
| Medicare Fee Schedule | $4.34 national non-facility rate (2026) · View Medicare rates for 94761 |
| Medicaid Fee Schedule | $3.44 median of the 8 states in the free preview · View Medicaid rates for 94761 |
National average reimbursement for CPT 94761 by major payers:
$5.64
$5.97
$6.15
$8.93
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CPT 94761
5 of 25 sample ratesHigher to lower in this preview
Mark Wainwright
Pediatric Faculty Foundation In
$11.52Published rateSteven Sharp
$7.65Published rateStacey Occomy
Advocate Health And Hospitals Corporation
$6.94Published rateJohn Millichap
Grady Memorial Hospital Corporation
$5.15Published rateLeanne Mcnabney
Town Center Orthopaedic Associates, P.C.
$3.92Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 94761 vs. Other Pulmonary Procedures Codes
The CPT 94761 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 94761 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 94761. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94761 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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