CPT code 94016: Spirometry review, professional interpretation only2026 Medicare rate & RVUs in Combine, Texas
CPT 94016: $24.29–$24.75 office ($24.29–$24.75 facility) across 2 localities in Combine, TX in 2026 Medicare. Compare each area.
Medicare pays $24.29–$24.75 for 94016 in the office in Combine, Texas, from Rest of Texas to Dallas, TX. Which amount applies depends on the service address.
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 6 sections
Where 94016 pays more and less in Combine, Texas
Combine, Texas maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.
| Payment locality | Office | Facility |
|---|---|---|
| Dallas, TX | $24.75 | $24.75 |
| Rest of Texas | $24.29 | $24.29 |
How payment areas work in Combine
City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.
- Dallas · Dallas County
- Rest Of State · Kaufman County
City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions
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.
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. |
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
Fee sheets · Coming soon
Put 94016 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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