CPT code 94016: Spirometry review, professional interpretation only2026 Medicare rate & RVUs in Delaware

Reports a clinician’s interpretation of patient-initiated spirometry recordings collected during a 30-day monitoring period, separate from the technical service.

CMS RVU26DEffective Oct 1, 2026One payment locality6.8K Medicare services in 2024

In Delaware, Medicare pays $24.65 for 94016 in the office and $24.65 when it’s performed in a hospital or facility.

$24.65Office (non-facility)
$24.65Hospital or facility
−0.3%vs the national office rate ($24.72)

Check a contract rate as a % of Medicare · 94016 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 94016 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 94016 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 94016 covers

This service covers a physician’s or other qualified health care professional’s review of spirometry recordings initiated by the patient, interpretation of the results, and a report. Patients typically make recordings with a spirometer outside the clinic as part of monitoring lung function over time; the clinician reviews the submitted data rather than performing a single office spirometry session. Pulmonary and primary care practices may use this service when following patients whose care includes home spirometry monitoring.

Report 94016 for the professional review and interpretation associated with a 30-day period, not for each individual recording. Documentation should identify the monitoring period, show that patient-initiated spirometry data were reviewed, and include the clinician’s interpretation and report. CMS classifies 94016 as professional-component-only; the technical portion is represented separately. When the recording service is reported under a separate technical code, keep the interpretation distinct from the equipment, recording, and data-handling work.

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 Delaware compares for 94016

Across 109 of 109 payment localities, the office rate for 94016 runs from $23.40 in Arkansas to $33.39 in Alaska. Delaware pays $24.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

94016 in Delaware vs other payment areas
  1. Delaware · this page$24.65
  2. Los Angeles, CA · California$26.47+$1.82
  3. Washington, DC area · District of Columbia$26.96+$2.31
  4. Miami, FL · Florida$26.03+$1.38
  5. Chicago, IL · Illinois$25.74+$1.09
  6. Manhattan, NY · New York$27.33+$2.68
  7. Alaska · Alaska$33.39+$8.74

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

Every other payment area

94016 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$23.55$23.55
ArkansasArkansas$23.40$23.40
ArizonaArizona$24.40$24.40
Bakersfield, CACalifornia$25.45$25.45
Chico, CACalifornia$25.37$25.37
El Centro, CACalifornia$25.37$25.37
Fresno, CACalifornia$25.37$25.37
Hanford, CACalifornia$25.37$25.37

94016 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.

$23.40

$33.39

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
94016 office rate range by state
State / territoryOffice rate rangeLocalities
AK$33.391
AL$23.551
AR$23.401
AZ$24.401
CA$25.37–$29.3829
CO$25.221
CT$25.741
DC$26.961
DE$24.651
FL$24.74–$26.033
GA$24.09–$25.012
GU$25.401
HI$25.401
IA$23.721
ID$23.801
IL$24.48–$25.744
IN$23.861
KS$23.711
KY$23.881
LA$23.88–$24.392
MA$25.23–$26.702
MD$24.92–$26.963
ME$23.90–$24.412
MI$24.19–$24.932
MN$24.451
MO$23.73–$24.383
MS$23.571
MT$24.721
NC$24.011
ND$24.321
NE$23.761
NH$24.921
NJ$26.11–$26.962
NM$24.271
NV$24.611
NY$24.17–$27.715
OH$24.111
OK$23.821
OR$24.49–$25.602
PA$24.10–$25.442
PR$24.781
RI$25.201
SC$24.081
SD$24.271
TN$23.771
TX$24.04–$25.088
UT$24.231
VA$24.40–$26.962
VI$24.781
VT$24.321
WA$25.15–$27.042
WI$23.961
WV$24.091
WY$24.541

See 94016 in every payment locality

How the 94016 rate is calculated

Each of 94016’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 · 94016

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.51

0.51 RVUs× 1.000 GPCI

Practice expense0.21

0.21 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.7400

Conversion factor

$33.4009

Medicare rate

$24.72

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,372

Code
94016
Physician work
0.51
Practice expense
0.21
Malpractice
0.02

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 94016 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.51× 1.0050.5125
Practice expense0.21× 0.9880.2075
Malpractice0.02× 0.8990.0180
Total RVUs0.7380
Conversion factor× 33.4009

Office rate, Delaware$24.65

Office: (0.51 × 1.005 + 0.21 × 0.988 + 0.02 × 0.899) × $33.4009 = $24.65

Facility: (0.51 × 1.005 + 0.21 × 0.988 + 0.02 × 0.899) × $33.4009 = $24.65

Open 94016 in the RVU calculator

Payment rules and modifiers for 94016

The CMS indicators that decide how 94016 is paid alongside other services.

CMS payment indicators · 94016

Spirometry review, professional interpretation only

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical2Professional component only.

How 94016 has changed in Delaware

94016 · Office / nonfacility

$24.65

Effective 2026-10-01

The base rate is $1.29 higher than on 2025-10-01, moving from $23.36 to $24.65 (5.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

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
  1. January 1, 2026

    RVU26A

    $23.36changed to$24.65

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.52 changed to 0.51
    • Practice expense RVU 0.18 changed to 0.21
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $24.04changed to$23.36

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $23.65changed to$24.04

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $24.52changed to$23.65

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949
  5. January 1, 2023

    RVU23A

    $25.09changed to$24.52

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $25.30changed to$25.09

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $26.25changed to$25.30

    • Conversion factor 36.0896 changed to 34.8931
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $26.29changed to$26.25

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $26.26changed to$26.29

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $26.26changed to$26.26

    • Conversion factor 35.8887 changed to 35.9996
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $26.26changed to$26.26

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $26.36changed to$26.26

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $26.23changed to$26.36

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $25.86changed to$26.23

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.01 changed to 0.02
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $24.53changed to$25.86

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $24.53

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$24.65$24.65RVU26D
2026-07-01$24.65$24.65RVU26C
2026-04-01$24.65$24.65RVU26B
2026-01-01$24.65$24.65RVU26A
2025-10-01$23.36$23.36RVU25D
2025-07-01$23.36$23.36RVU25C
2025-04-01$23.36$23.36RVU25B
2025-01-01$23.36$23.36RVU25A
2024-10-01$24.04$24.04RVU24D
2024-07-01$24.04$24.04RVU24C
2024-04-01$24.04$24.04RVU24B
2024-03-09$24.04$24.04RVU24AR
2024-01-01$23.65$23.65RVU24A
2023-10-01$24.52$24.52RVU23D
2023-07-01$24.52$24.52RVU23C
2023-04-01$24.52$24.52RVU23B
2023-01-01$24.52$24.52RVU23A
2022-10-01$25.09$25.09RVU22D
2022-07-01$25.09$25.09RVU22C
2022-04-01$25.09$25.09RVU22B
2022-01-01$25.09$25.09RVU22A
2021-10-01$25.30$25.30RVU21D
2021-07-01$25.30$25.30RVU21C
2021-04-01$25.30$25.30RVU21B
2021-01-01$25.30$25.30RVU21A
2020-10-01$26.25$26.25RVU20D
2020-07-01$26.25$26.25RVU20C
2020-04-01$26.25$26.25RVU20B
2020-01-01$26.25$26.25RVU20A
2019-10-01$26.29$26.29RVU19D
2019-07-01$26.29$26.29RVU19C
2019-04-01$26.29$26.29RVU19B
2019-01-01$26.29$26.29RVU19A
2018-10-01$26.26$26.26RVU18D
2018-07-01$26.26$26.26RVU18C
2018-04-01$26.26$26.26RVU18B
2018-01-01$26.26$26.26RVU18AR1
2017-10-01$26.26$26.26RVU17D
2017-07-01$26.26$26.26RVU17C
2017-04-01$26.26$26.26RVU17B
2017-01-01$26.26$26.26RVU17A
2016-10-01$26.26$26.26RVU16D
2016-07-01$26.26$26.26RVU16C
2016-04-01$26.26$26.26RVU16B
2016-01-01$26.26$26.26RVU16A
2015-10-01$26.36$26.36RVU15D
2015-07-01$26.36$26.36RVU15C
2015-04-01$26.23$26.23RVU15B
2015-01-01$26.23$26.23RVU15A
2014-10-01$25.86$25.86RVU14D
2014-07-01$25.86$25.86RVU14C
2014-04-01$25.86$25.86RVU14B
2014-01-01$25.86$25.86RVU14A
2013-10-01$24.53$24.53RVU13D
2013-07-01$24.53$24.53RVU13C
2013-04-01$24.53$24.53RVU13B
2013-01-01$24.53$24.53RVU13AR

Price 94016 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

94016 billing questions

How does 94016 differ from 94014?

94016 represents professional review, interpretation, and reporting. Code 94014 represents the technical recording service.

Can 94016 be reported with 94014?

Yes, when the technical recording service and the professional interpretation are both furnished and documented for the monitoring period.

Does 94016 need modifier 26?

No modifier is needed to identify the professional component; 94016 is already a professional-component-only code.

Is 94016 reported for each home spirometry maneuver?

No. The code is for review and reporting over a 30-day period, rather than for each individual recording.

What documentation supports 94016?

Keep the monitoring period, evidence that the patient-initiated recordings were reviewed, the clinician’s interpretation, and the resulting report.

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 94016PPRRVU2026_Oct_nonQPP.csv, line 12,372 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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