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

In Utah, Medicare pays $103.69 for 94626 in the office and $23.94 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 94626 nationwide

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.

How Utah compares for 94626

Across 109 of 109 payment localities, the office rate for 94626 runs from $95.65 in Arkansas to $149.17 in San Benito County, CA. Utah pays $103.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

94626 rates by state

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

See 94626 in every payment locality

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.

Codes related to 94626

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

How 94626 has changed in Utah

Price 94626 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

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