CPT code 94621: Exercise test, cardiopulmonary gas analysis2026 Medicare rate & RVUs in Maryland
Reports integrated exercise testing with oxygen uptake and carbon dioxide measurement to assess the cause of exertional breathlessness or limited exercise capacity.
Medicare pays $167.28–$189.25 for 94621 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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 94621 covers
This test evaluates heart and lung responses during controlled exercise by measuring oxygen uptake and carbon dioxide production as workload increases. It is used when symptoms such as unexplained exertional dyspnea or poor exercise tolerance require assessment of cardiopulmonary function. Testing is commonly performed in a pulmonary or cardiac function laboratory, with trained staff conducting the exercise protocol and a qualified clinician interpreting the results.
Select 94621 when the service is a comprehensive cardiopulmonary exercise evaluation, rather than a simpler pulmonary stress test or a test aimed specifically at exercise-induced bronchospasm. Documentation should identify the clinical indication, exercise protocol, measurements obtained, patient response, and interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier when billing 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 94621 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$167.28 to $189.25
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $175.63 | Unavailable |
| Rest of Maryland | $167.28 | Unavailable |
| Washington, DC area | $189.25 | Unavailable |
How the 94621 rate is calculated
Each of 94621’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 · 94621
RVUs × geographic indexes × conversion factor
Work1.38
1.38 RVUs× 1.000 GPCI
Practice expense3.49
3.49 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
4.9600
Conversion factor
$33.4009
Medicare rate
$165.67
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 94621
The CMS indicators that decide how 94621 is paid alongside other services.
CMS payment indicators · 94621
Exercise test, cardiopulmonary gas analysis
| 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
94621 without 26 · national office
$165.67
Exercise test, cardiopulmonary gas analysis
94621-26 · Professional component
$67.80
Pays only the interpretation and report.
94621 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 94618Pulmonary stress testSimple exercise assessment
- 94621 is the comprehensive cardiopulmonary test with oxygen uptake and carbon dioxide measurement. 94618 describes pulmonary stress testing without that same comprehensive gas-analysis focus.
- 94617Exercise bronchospasm testWith ECG
- Choose 94617 when the exercise test is intended to evaluate bronchospasm and includes ECG recording; 94621 evaluates broader cardiopulmonary responses during exercise.
- 94619Exercise challengeWithout ECG recording
- 94619 targets exercise-induced bronchospasm without ECG recording. 94621 is the comprehensive cardiopulmonary exercise evaluation.
- 94681Gas-exchange analysisCO2 output and derived measures
- 94681 focuses on oxygen uptake, carbon dioxide output, and oxygen extraction measurements. 94621 describes a comprehensive exercise evaluation rather than gas-exchange measurement alone.
94621 billing questions
When should 94621 be chosen over 94618?
Use 94621 for an integrated cardiopulmonary exercise evaluation with oxygen uptake and carbon dioxide measurement. Code 94618 is for pulmonary stress testing without that comprehensive gas-analysis focus.
How does 94621 differ from exercise bronchospasm testing?
94621 evaluates cardiopulmonary responses to exercise. Codes 94617 and 94619 are directed at exercise-induced bronchospasm; 94617 includes ECG recording, while 94619 is without it.
Which modifier reports the interpretation?
Use modifier 26 for the professional component, which represents interpretation. Modifier TC identifies the technical component for equipment and staff; reporting without either modifier represents the global service.
What documentation supports reporting 94621?
Document the reason for testing, exercise protocol, oxygen uptake and carbon dioxide measurements, patient response, and the clinician's interpretation.
Can the technical and professional components be billed separately?
Yes. CMS identifies separately priced professional and technical components for this diagnostic test, reported with modifiers 26 and TC, respectively.
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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