CPT code 94016: Spirometry review, professional interpretation only2026 Medicare rate & RVUs in South Carolina
Reports a clinician’s interpretation of patient-initiated spirometry recordings collected during a 30-day monitoring period, separate from the technical service.
In South Carolina, Medicare pays $24.08 for 94016 in the office and $24.08 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Carolina 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. South Carolina pays $24.08. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$24.08
- Los Angeles, CA · California$26.47+$2.39
- Washington, DC area · District of Columbia$26.96+$2.88
- Miami, FL · Florida$26.03+$1.95
- Chicago, IL · Illinois$25.74+$1.66
- Manhattan, NY · New York$27.33+$3.25
- Alaska · Alaska$33.39+$9.31
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $25.37 | $25.37 |
| Merced, CACalifornia | $25.37 | $25.37 |
| Modesto, CACalifornia | $25.37 | $25.37 |
| Napa, CACalifornia | $27.69 | $27.69 |
| Oxnard, CACalifornia | $26.22 | $26.22 |
| Redding, CACalifornia | $25.37 | $25.37 |
| Rest of CaliforniaCalifornia | $25.37 | $25.37 |
| Riverside, CACalifornia | $25.60 | $25.60 |
| Sacramento, CACalifornia | $26.16 | $26.16 |
| Salinas, CACalifornia | $26.05 | $26.05 |
| San Diego, CACalifornia | $26.30 | $26.30 |
| Marin County, CACalifornia | $28.85 | $28.85 |
| San Francisco, CACalifornia | $28.83 | $28.83 |
| San Benito County, CACalifornia | $29.38 | $29.38 |
| Santa Clara County, CACalifornia | $29.29 | $29.29 |
| San Luis Obispo, CACalifornia | $25.67 | $25.67 |
| Santa Cruz, CACalifornia | $26.27 | $26.27 |
| Santa Maria, CACalifornia | $26.05 | $26.05 |
| Santa Rosa, CACalifornia | $26.52 | $26.52 |
| Stockton, CACalifornia | $25.37 | $25.37 |
| Vallejo, CACalifornia | $27.66 | $27.66 |
| Visalia, CACalifornia | $25.37 | $25.37 |
| Yuba City, CACalifornia | $25.37 | $25.37 |
| ColoradoColorado | $25.22 | $25.22 |
| ConnecticutConnecticut | $25.74 | $25.74 |
| DelawareDelaware | $24.65 | $24.65 |
| Fort Lauderdale, FLFlorida | $25.35 | $25.35 |
| Rest of FloridaFlorida | $24.74 | $24.74 |
| Atlanta, GAGeorgia | $25.01 | $25.01 |
| Rest of GeorgiaGeorgia | $24.09 | $24.09 |
| Hawaii, Guam, HIHawaii | $25.40 | $25.40 |
| IowaIowa | $23.72 | $23.72 |
| IdahoIdaho | $23.80 | $23.80 |
| East St. Louis, ILIllinois | $24.83 | $24.83 |
| Rest of IllinoisIllinois | $24.48 | $24.48 |
| Suburban Chicago, ILIllinois | $25.54 | $25.54 |
| IndianaIndiana | $23.86 | $23.86 |
| KansasKansas | $23.71 | $23.71 |
| KentuckyKentucky | $23.88 | $23.88 |
| New Orleans, LALouisiana | $24.39 | $24.39 |
| Rest of LouisianaLouisiana | $23.88 | $23.88 |
| Metropolitan Boston, MAMassachusetts | $26.70 | $26.70 |
| Rest of MassachusettsMassachusetts | $25.23 | $25.23 |
| Baltimore area, MDMaryland | $25.66 | $25.66 |
| Rest of MarylandMaryland | $24.92 | $24.92 |
| Rest of MaineMaine | $23.90 | $23.90 |
| Southern Maine, MEMaine | $24.41 | $24.41 |
| Detroit, MIMichigan | $24.93 | $24.93 |
| Rest of MichiganMichigan | $24.19 | $24.19 |
| MinnesotaMinnesota | $24.45 | $24.45 |
| Metropolitan Kansas City, MOMissouri | $24.27 | $24.27 |
| Metropolitan St. Louis, MOMissouri | $24.38 | $24.38 |
| Rest of MissouriMissouri | $23.73 | $23.73 |
| MississippiMississippi | $23.57 | $23.57 |
| MontanaMontana | $24.72 | $24.72 |
| North CarolinaNorth Carolina | $24.01 | $24.01 |
| North DakotaNorth Dakota | $24.32 | $24.32 |
| NebraskaNebraska | $23.76 | $23.76 |
| New HampshireNew Hampshire | $24.92 | $24.92 |
| Northern New JerseyNew Jersey | $26.96 | $26.96 |
| Rest of New JerseyNew Jersey | $26.11 | $26.11 |
| New MexicoNew Mexico | $24.27 | $24.27 |
| NevadaNevada | $24.61 | $24.61 |
| NYC suburbs and Long Island, NYNew York | $27.71 | $27.71 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $26.29 | $26.29 |
| Queens, NYNew York | $27.38 | $27.38 |
| Rest of New YorkNew York | $24.17 | $24.17 |
| OhioOhio | $24.11 | $24.11 |
| OklahomaOklahoma | $23.82 | $23.82 |
| Portland, OROregon | $25.60 | $25.60 |
| Rest of OregonOregon | $24.49 | $24.49 |
| Metropolitan Philadelphia, PAPennsylvania | $25.44 | $25.44 |
| Rest of PennsylvaniaPennsylvania | $24.10 | $24.10 |
| Puerto RicoPuerto Rico | $24.78 | $24.78 |
| Rhode IslandRhode Island | $25.20 | $25.20 |
| South DakotaSouth Dakota | $24.27 | $24.27 |
| TennesseeTennessee | $23.77 | $23.77 |
| Austin, TXTexas | $25.08 | $25.08 |
| Beaumont, TXTexas | $24.04 | $24.04 |
| Brazoria, TXTexas | $24.64 | $24.64 |
| Dallas, TXTexas | $24.75 | $24.75 |
| Fort Worth, TXTexas | $24.69 | $24.69 |
| Galveston, TXTexas | $24.69 | $24.69 |
| Houston, TXTexas | $25.06 | $25.06 |
| Rest of TexasTexas | $24.29 | $24.29 |
| UtahUtah | $24.23 | $24.23 |
| VirginiaVirginia | $24.40 | $24.40 |
| Virgin Islands, VIUnited States Virgin Islands | $24.78 | $24.78 |
| VermontVermont | $24.32 | $24.32 |
| Rest of WashingtonWashington | $25.15 | $25.15 |
| King County, WAWashington | $27.04 | $27.04 |
| WisconsinWisconsin | $23.96 | $23.96 |
| West VirginiaWest Virginia | $24.09 | $24.09 |
| WyomingWyoming | $24.54 | $24.54 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $33.39 | 1 |
| AL | $23.55 | 1 |
| AR | $23.40 | 1 |
| AZ | $24.40 | 1 |
| CA | $25.37–$29.38 | 29 |
| CO | $25.22 | 1 |
| CT | $25.74 | 1 |
| DC | $26.96 | 1 |
| DE | $24.65 | 1 |
| FL | $24.74–$26.03 | 3 |
| GA | $24.09–$25.01 | 2 |
| GU | $25.40 | 1 |
| HI | $25.40 | 1 |
| IA | $23.72 | 1 |
| ID | $23.80 | 1 |
| IL | $24.48–$25.74 | 4 |
| IN | $23.86 | 1 |
| KS | $23.71 | 1 |
| KY | $23.88 | 1 |
| LA | $23.88–$24.39 | 2 |
| MA | $25.23–$26.70 | 2 |
| MD | $24.92–$26.96 | 3 |
| ME | $23.90–$24.41 | 2 |
| MI | $24.19–$24.93 | 2 |
| MN | $24.45 | 1 |
| MO | $23.73–$24.38 | 3 |
| MS | $23.57 | 1 |
| MT | $24.72 | 1 |
| NC | $24.01 | 1 |
| ND | $24.32 | 1 |
| NE | $23.76 | 1 |
| NH | $24.92 | 1 |
| NJ | $26.11–$26.96 | 2 |
| NM | $24.27 | 1 |
| NV | $24.61 | 1 |
| NY | $24.17–$27.71 | 5 |
| OH | $24.11 | 1 |
| OK | $23.82 | 1 |
| OR | $24.49–$25.60 | 2 |
| PA | $24.10–$25.44 | 2 |
| PR | $24.78 | 1 |
| RI | $25.20 | 1 |
| SC | $24.08 | 1 |
| SD | $24.27 | 1 |
| TN | $23.77 | 1 |
| TX | $24.04–$25.08 | 8 |
| UT | $24.23 | 1 |
| VA | $24.40–$26.96 | 2 |
| VI | $24.78 | 1 |
| VT | $24.32 | 1 |
| WA | $25.15–$27.04 | 2 |
| WI | $23.96 | 1 |
| WV | $24.09 | 1 |
| WY | $24.54 | 1 |
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
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 South Carolina 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
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.51 | × 1.000 | 0.5100 |
| Practice expense | 0.21 | × 0.924 | 0.1940 |
| Malpractice | 0.02 | × 0.850 | 0.0170 |
| Total RVUs | 0.7210 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$24.08
Office: (0.51 × 1 + 0.21 × 0.924 + 0.02 × 0.85) × $33.4009 = $24.08
Facility: (0.51 × 1 + 0.21 × 0.924 + 0.02 × 0.85) × $33.4009 = $24.08
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 2 | Professional component only. |
How 94016 has changed in South Carolina
94016 · Office / nonfacility
$24.08
Effective 2026-10-01
The base rate is $1.42 higher than on 2025-10-01, moving from $22.66 to $24.08 (6.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$22.66changed to$24.08
- 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
- Practice expense GPCI 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$23.32changed to$22.66
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$22.94changed to$23.32
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$23.67changed to$22.94
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$24.10changed to$23.67
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$24.30changed to$24.10
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$25.11changed to$24.30
- Conversion factor 36.0896 changed to 34.8931
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$25.06changed to$25.11
- Conversion factor 36.0391 changed to 36.0896
- Practice expense GPCI 0.912 changed to 0.907
- Malpractice GPCI 0.553 changed to 0.624
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$25.03changed to$25.06
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$25.01changed to$25.03
- Conversion factor 35.8887 changed to 35.9996
- Malpractice GPCI 0.634 changed to 0.553
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$25.01changed to$25.01
- Conversion factor 35.8043 changed to 35.8887
- Malpractice GPCI 0.715 changed to 0.634
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$25.10changed to$25.01
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$24.97changed to$25.10
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$24.72changed to$24.97
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.01 changed to 0.02
- Practice expense GPCI 0.911 changed to 0.912
- Malpractice GPCI 0.618 changed to 0.715
Held through RVU15B.
January 1, 2014
RVU14A
$23.44changed to$24.72
- Conversion factor 34.0230 changed to 35.8228
- Practice expense GPCI 0.909 changed to 0.911
- Malpractice GPCI 0.520 changed to 0.618
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $23.44
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $24.08 | $24.08 | RVU26D |
| 2026-07-01 | $24.08 | $24.08 | RVU26C |
| 2026-04-01 | $24.08 | $24.08 | RVU26B |
| 2026-01-01 | $24.08 | $24.08 | RVU26A |
| 2025-10-01 | $22.66 | $22.66 | RVU25D |
| 2025-07-01 | $22.66 | $22.66 | RVU25C |
| 2025-04-01 | $22.66 | $22.66 | RVU25B |
| 2025-01-01 | $22.66 | $22.66 | RVU25A |
| 2024-10-01 | $23.32 | $23.32 | RVU24D |
| 2024-07-01 | $23.32 | $23.32 | RVU24C |
| 2024-04-01 | $23.32 | $23.32 | RVU24B |
| 2024-03-09 | $23.32 | $23.32 | RVU24AR |
| 2024-01-01 | $22.94 | $22.94 | RVU24A |
| 2023-10-01 | $23.67 | $23.67 | RVU23D |
| 2023-07-01 | $23.67 | $23.67 | RVU23C |
| 2023-04-01 | $23.67 | $23.67 | RVU23B |
| 2023-01-01 | $23.67 | $23.67 | RVU23A |
| 2022-10-01 | $24.10 | $24.10 | RVU22D |
| 2022-07-01 | $24.10 | $24.10 | RVU22C |
| 2022-04-01 | $24.10 | $24.10 | RVU22B |
| 2022-01-01 | $24.10 | $24.10 | RVU22A |
| 2021-10-01 | $24.30 | $24.30 | RVU21D |
| 2021-07-01 | $24.30 | $24.30 | RVU21C |
| 2021-04-01 | $24.30 | $24.30 | RVU21B |
| 2021-01-01 | $24.30 | $24.30 | RVU21A |
| 2020-10-01 | $25.11 | $25.11 | RVU20D |
| 2020-07-01 | $25.11 | $25.11 | RVU20C |
| 2020-04-01 | $25.11 | $25.11 | RVU20B |
| 2020-01-01 | $25.11 | $25.11 | RVU20A |
| 2019-10-01 | $25.06 | $25.06 | RVU19D |
| 2019-07-01 | $25.06 | $25.06 | RVU19C |
| 2019-04-01 | $25.06 | $25.06 | RVU19B |
| 2019-01-01 | $25.06 | $25.06 | RVU19A |
| 2018-10-01 | $25.03 | $25.03 | RVU18D |
| 2018-07-01 | $25.03 | $25.03 | RVU18C |
| 2018-04-01 | $25.03 | $25.03 | RVU18B |
| 2018-01-01 | $25.03 | $25.03 | RVU18AR1 |
| 2017-10-01 | $25.01 | $25.01 | RVU17D |
| 2017-07-01 | $25.01 | $25.01 | RVU17C |
| 2017-04-01 | $25.01 | $25.01 | RVU17B |
| 2017-01-01 | $25.01 | $25.01 | RVU17A |
| 2016-10-01 | $25.01 | $25.01 | RVU16D |
| 2016-07-01 | $25.01 | $25.01 | RVU16C |
| 2016-04-01 | $25.01 | $25.01 | RVU16B |
| 2016-01-01 | $25.01 | $25.01 | RVU16A |
| 2015-10-01 | $25.10 | $25.10 | RVU15D |
| 2015-07-01 | $25.10 | $25.10 | RVU15C |
| 2015-04-01 | $24.97 | $24.97 | RVU15B |
| 2015-01-01 | $24.97 | $24.97 | RVU15A |
| 2014-10-01 | $24.72 | $24.72 | RVU14D |
| 2014-07-01 | $24.72 | $24.72 | RVU14C |
| 2014-04-01 | $24.72 | $24.72 | RVU14B |
| 2014-01-01 | $24.72 | $24.72 | RVU14A |
| 2013-10-01 | $23.44 | $23.44 | RVU13D |
| 2013-07-01 | $23.44 | $23.44 | RVU13C |
| 2013-04-01 | $23.44 | $23.44 | RVU13B |
| 2013-01-01 | $23.44 | $23.44 | RVU13AR |
Where the South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
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
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