CPT code 94011: Infant spirometry, age 2 years or younger2026 Medicare rate & RVUs in Utah

Reports specialized spirometry for a child age 2 years or younger, measuring vital capacity and expiratory flow with infant-appropriate testing methods.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Utah, Medicare pays $70.80 for 94011 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$70.80Hospital or facility

Check a contract rate as a % of Medicare · 94011 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 94011 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 94011 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 94011 covers

94011 represents pulmonary function testing adapted for infants who cannot reliably perform routine spirometry maneuvers. The test produces a graphic record and measurements of vital capacity and expiratory flow using techniques and equipment suited to a child age 2 or younger. It is typically performed by a pulmonary function laboratory or pediatric pulmonary service in an outpatient clinic or hospital when evaluating respiratory symptoms such as wheezing or suspected obstructive disease.

Choose this code based on the patient’s age and the infant spirometry performed, not simply because a young child had a breathing assessment. Document the indication, the child’s age, the testing method, and the resulting curves or measurements. Report additional infant lung-volume or enhanced spirometry services only when those distinct procedures are performed and documented. CMS values the service through physician-work, practice-expense, and malpractice inputs; use the applicable fee schedule rate for the claim’s payment context.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Utah compares for 94011

Across 109 of 109 payment localities, the facility rate for 94011 runs from $68.71 in Arkansas to $99.78 in Alaska. Utah pays $70.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

94011 in Utah vs other payment areas
  1. Utah · this page$70.80
  2. Los Angeles, CA · California$75.28+$4.48
  3. Washington, DC area · District of Columbia$77.32+$6.52
  4. Miami, FL · Florida$76.89+$6.09
  5. Chicago, IL · Illinois$76.16+$5.36
  6. Manhattan, NY · New York$79.12+$8.32
  7. Alaska · Alaska$99.78+$28.98

Other areas in Utah first, then benchmark localities. Bars start at $0.

Every other payment area

94011 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$69.05
ArkansasArkansas—$68.71
ArizonaArizona—$71.02
Bakersfield, CACalifornia—$72.84
Chico, CACalifornia—$72.51
El Centro, CACalifornia—$72.53
Fresno, CACalifornia—$72.51
Hanford, CACalifornia—$72.51

94011 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
94011 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 94011 in every payment locality

How the 94011 rate is calculated

Each of 94011’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 94011

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.71

1.71 RVUs× 1.000 GPCI

Practice expense0.35

0.35 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

2.1500

Conversion factor

$33.4009

Medicare rate

$71.81

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,367

Code
94011
Physician work
1.71
Practice expense
0.35
Malpractice
0.09

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Facility calculation for 94011 in Utah
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0001.7100
Practice expense0.35× 0.9400.3290
Malpractice0.09× 0.8980.0808
Total RVUs2.1198
Conversion factor× 33.4009

Facility rate, Utah$70.80

Facility: (1.71 × 1 + 0.35 × 0.94 + 0.09 × 0.898) × $33.4009 = $70.80

Open 94011 in the RVU calculator

Payment rules and modifiers for 94011

94011 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 94011

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

94011 isn’t priced in this setting.

How 94011 has changed in Utah

94011 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$70.80RVU26D
2026-07-01Not available in this setting$70.80RVU26C
2026-04-01Not available in this setting$70.80RVU26B
2026-01-01Not available in this setting$70.80RVU26A
2025-10-01Not available in this setting$79.53RVU25D
2025-07-01Not available in this setting$79.53RVU25C
2025-04-01Not available in this setting$79.53RVU25B
2025-01-01Not available in this setting$79.53RVU25A
2024-10-01Not available in this setting$81.84RVU24D
2024-07-01Not available in this setting$81.84RVU24C
2024-04-01Not available in this setting$81.84RVU24B
2024-03-09Not available in this setting$81.84RVU24AR
2024-01-01Not available in this setting$80.51RVU24A
2023-10-01Not available in this setting$82.90RVU23D
2023-07-01Not available in this setting$82.90RVU23C
2023-04-01Not available in this setting$82.90RVU23B
2023-01-01Not available in this setting$82.90RVU23A
2022-10-01Not available in this setting$84.27RVU22D
2022-07-01Not available in this setting$84.27RVU22C
2022-04-01Not available in this setting$84.27RVU22B
2022-01-01Not available in this setting$84.27RVU22A
2021-10-01Not available in this setting$84.57RVU21D
2021-07-01Not available in this setting$84.57RVU21C
2021-04-01Not available in this setting$84.57RVU21B
2021-01-01Not available in this setting$84.57RVU21A
2020-10-01Not available in this setting$87.04RVU20D
2020-07-01Not available in this setting$87.04RVU20C
2020-04-01Not available in this setting$87.04RVU20B
2020-01-01Not available in this setting$87.04RVU20A
2019-10-01Not available in this setting$88.07RVU19D
2019-07-01Not available in this setting$88.07RVU19C
2019-04-01Not available in this setting$88.49RVU19B
2019-01-01Not available in this setting$88.49RVU19A
2018-10-01Not available in this setting$87.97RVU18D
2018-07-01Not available in this setting$87.97RVU18C
2018-04-01Not available in this setting$87.97RVU18B
2018-01-01Not available in this setting$87.97RVU18AR1
2017-10-01Not available in this setting$92.31RVU17D
2017-07-01Not available in this setting$92.31RVU17C
2017-04-01Not available in this setting$92.31RVU17B
2017-01-01Not available in this setting$92.31RVU17A
2016-10-01Not available in this setting$102.80RVU16D
2016-07-01Not available in this setting$102.80RVU16C
2016-04-01Not available in this setting$102.80RVU16B
2016-01-01Not available in this setting$102.80RVU16A
2015-10-01Not available in this setting$100.76RVU15D
2015-07-01Not available in this setting$100.76RVU15C
2015-04-01Not available in this setting$100.26RVU15B
2015-01-01Not available in this setting$100.26RVU15A
2014-10-01Not available in this setting$102.29RVU14D
2014-07-01Not available in this setting$102.29RVU14C
2014-04-01Not available in this setting$102.29RVU14B
2014-01-01Not available in this setting$102.29RVU14A
2013-10-01Not available in this setting$97.29RVU13D
2013-07-01Not available in this setting$97.29RVU13C
2013-04-01Not available in this setting$97.29RVU13B
2013-01-01Not available in this setting$97.29RVU13AR

Price 94011 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

94011 billing questions

How is 94011 different from 94010?

94011 is for infant spirometry in a child age 2 or younger, using testing suited to the infant. 94010 is the general spirometry code for patients who can perform standard spirometry maneuvers.

When should 94012 be used instead?

Use 94012 when the infant spirometry service includes the additional flow-volume loop or bronchodilator-responsiveness testing represented by that code. Do not select it solely because the patient is an infant.

Are the graphic record and flow measurements separate services?

The graphic record and vital-capacity and expiratory-flow measurements are elements of 94011. They are not separately reported as individual services when they are part of the same infant spirometry test.

What documentation supports reporting 94011?

Document the child’s age, the clinical reason for testing, the infant-appropriate spirometry performed, and the resulting measurements or tracing. The record should distinguish any separately performed lung-volume or enhanced spirometry testing.

Is 94011 reported once per maneuver?

No. Report the infant spirometry service, not each individual maneuver or tracing.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 94011PPRRVU2026_Oct_nonQPP.csv, line 12,367 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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