CPT code 94070: Wheezing evaluation, bronchial challenge testing2026 Medicare rate & RVUs in Texas
Reports bronchial provocation with repeated spirometry to assess suspected airway hyperreactivity, often when ordinary spirometry has not explained episodic wheezing.
Medicare pays $65.33–$72.47 for 94070 in the office in Texas, from Beaumont, TX to Austin, 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.
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On this page 9 sections
What 94070 covers
This test evaluates airway response to a provoking stimulus through repeated spirometric measurements. A pulmonary function laboratory may administer an inhaled agent such as methacholine, or use another stimulus such as cold air or an allergen, while recording changes in airflow. Pulmonologists and allergists commonly order it when asthma or airway hyperreactivity is suspected but routine spirometry has not established the diagnosis. Testing is typically performed by trained pulmonary function staff, with a qualified professional interpreting the results.
Report 94070 for the provocation evaluation and its serial spirometry, rather than for routine spirometry alone or a bronchodilator response test. Documentation should identify the stimulus, show the baseline and subsequent measurements, and support the interpretation of the airway response. The repeated spirometric determinations performed as part of the challenge are included in this service. CMS recognizes professional and technical components: report modifier 26 for interpretation only, modifier TC for equipment and staff only, or no component modifier for the global service.
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 94070 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$65.33 to $72.47
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $72.47 | Unavailable |
| Beaumont, TX | $65.33 | Unavailable |
| Brazoria, TX | $69.16 | Unavailable |
| Dallas, TX | $69.55 | Unavailable |
| Fort Worth, TX | $69.09 | Unavailable |
| Galveston, TX | $69.34 | Unavailable |
| Houston, TX | $70.25 | Unavailable |
| Rest of Texas | $67.18 | Unavailable |
How the 94070 rate is calculated
Each of 94070’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 · 94070
RVUs × geographic indexes × conversion factor
Work0.59
0.59 RVUs× 1.000 GPCI
Practice expense1.45
1.45 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
2.0900
Conversion factor
$33.4009
Medicare rate
$69.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 94070
The CMS indicators that decide how 94070 is paid alongside other services.
CMS payment indicators · 94070
Wheezing evaluation, bronchial challenge testing
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
94070 without 26 · national office
$69.81
Wheezing evaluation, bronchial challenge testing
94070-26 · Professional component
$28.72
Pays only the interpretation and report.
94070 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 94010SpirometryNo post-bronchodilator comparison
- 94010 reports routine spirometry. Use 94070 when a provoking stimulus is administered and serial measurements assess airway response.
- 94060Bronchodilator spirometryPre- and post-bronchodilator testing
- 94060 evaluates response to a bronchodilator using pre- and post-medication spirometry. 94070 evaluates response to a bronchial provocation stimulus.
- 94012Infant spirometryWith bronchodilator
- 94012 is an age-specific spirometry service for a child under 2 years receiving bronchodilator testing; it is not a bronchial provocation evaluation.
94070 billing questions
When should 94070 be chosen instead of 94060?
Choose 94070 when the evaluation uses a provoking stimulus and repeated spirometry to assess airway hyperreactivity. Use 94060 for spirometry before and after a bronchodilator.
Can the spirometry measurements during the challenge be billed separately?
The serial spirometric determinations performed as part of the challenge are included in 94070. Do not separately report 94010 for those same measurements.
How should the professional and technical portions be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting 94070?
Document the challenge stimulus, baseline and subsequent spirometry results, and the professional interpretation of the response. The record should show that the service was a provocation evaluation, not routine spirometry alone.
Is 94070 appropriate when only baseline spirometry is performed?
No. 94070 describes provocation testing with multiple spirometric determinations; routine breathing-capacity testing is represented by 94010.
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
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