CPT code 94626: Pulmonary rehab, with continuous oximetry2026 Medicare rate & RVUs

Medicare pays $109.22 for 94626 nationally in the office and $24.38 in a hospital or facility. Local office rates run $95.65–$149.17.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 94626 covers

This service covers a session of outpatient pulmonary rehabilitation that includes continuous oximetry monitoring. It is used for patients with chronic respiratory disease who need structured rehabilitation, commonly people with COPD working to improve exercise tolerance and manage breathlessness. A physician or other qualified health care professional provides the service; rehabilitation staff may support exercise and other session activities. The oximetry monitors oxygen saturation continuously during the session, rather than only at selected points.

Report one unit for the rehabilitation session, not for each exercise or monitoring interval. Documentation should identify the patient’s pulmonary rehabilitation session, the services performed, and the continuous oximetry monitoring. Code 94625 is the sibling option when the session is performed without continuous oximetry. Continuous monitoring distinguishes 94626 from that code; it is not an additional service to report separately from the session code.

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 94626 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

94626 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 94626 rate is calculated

Each of 94626’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.

Payment rules and modifiers for 94626

94626 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

94626 compared with similar codes

How to choose

94625Pulmonary rehabWithout continuous ECG monitoring

Choose 94626 when the pulmonary rehabilitation session includes continuous oximetry; 94625 describes the session without that monitoring.

94618Pulmonary stress testSimple exercise assessment

94618 reports pulmonary stress testing to assess exercise response. It is not a session of ongoing outpatient pulmonary rehabilitation.

94621Exercise testCardiopulmonary gas analysis

94621 is cardiopulmonary exercise testing, a diagnostic assessment of exercise capacity; 94626 is a pulmonary rehabilitation session with continuous oximetry.

Codes related to 94626

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates