CPT code 94013: Lung-volume test, through age 22026 Medicare rate & RVUs in Missouri
Reports spirometry-technique lung-volume measurement in a child through age 2 as part of an age-specific pulmonary function assessment.
CMS doesn’t publish an office rate for 94013 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 94013 covers
This service measures lung volumes using a spirometry technique in children through age 2. It is generally performed in a specialized pediatric pulmonary function laboratory by trained pulmonary function staff, such as a respiratory therapist, with physician oversight. The results help characterize pulmonary function when standard testing requiring active cooperation is not suitable for the child’s age.
Select the code when the documented service measures lung volumes, rather than only expiratory airflow or bronchodilator response. The record should support the child’s age, the spirometry technique, and the lung-volume measurements obtained. The Medicare Physician Fee Schedule represents payment through work, practice-expense, and malpractice RVUs; the practice-expense RVU listed for this code is the same in office and facility settings.
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.
Where 94013 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $16.53 |
| Metropolitan St. Louis, MO | Unavailable | $16.59 |
| Rest of Missouri | Unavailable | $16.35 |
How the 94013 rate is calculated
Each of 94013’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 · 94013
RVUs × geographic indexes × conversion factor
Work0.40
0.40 RVUs× 1.000 GPCI
Practice expense0.07
0.07 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
0.5000
Conversion factor
$33.4009
Medicare rate
$16.70
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 94013
94013 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 · 94013
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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94013 isn’t priced in this setting.
94013 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 94011Infant spirometryAge 2 years or younger
- Use 94011 for the infant spirometry service focused on breathing-capacity and expiratory-flow measurements; 94013 identifies lung-volume measurement.
- 94012Infant spirometryWith bronchodilator
- 94012 is the infant spirometry service that includes bronchodilator responsiveness testing. 94013 identifies lung-volume measurement by spirometry technique.
- 94010SpirometryNo post-bronchodilator comparison
- 94010 is the general spirometry code. 94013 is specific to spirometry-technique lung-volume measurement in children through age 2.
- 94726Body plethysmographyLung volumes, plethysmographic method
- Choose 94013 for lung-volume measurement using a spirometry technique; 94726 is for lung-volume determination by plethysmography.
94013 billing questions
Which children qualify by age?
The code is for children through age 2. For an older child, use the code that matches the pulmonary function service performed and the applicable age-specific coding.
How does this differ from 94011?
94013 identifies lung-volume measurement by spirometry technique. 94011 describes infant spirometry focused on breathing-capacity and expiratory-flow measurements.
Is this the infant code for bronchodilator testing?
No. 94012 is the infant spirometry code that includes bronchodilator responsiveness testing; 94013 identifies lung-volume measurement.
What documentation supports reporting 94013?
Document the child’s age, the spirometry technique used, and the lung-volume measurements obtained. The test report should make clear that lung volumes were measured, not merely airflow.
How does 94013 differ from plethysmography?
94013 identifies lung-volume measurement by spirometry technique. Code 94726 describes lung-volume determination by plethysmography.
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
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