CPT code 94690: Metabolic testing, resting oxygen uptake2026 Medicare rate & RVUs in Ohio

Measures oxygen uptake at rest by indirect calorimetry to estimate resting energy expenditure when a patient’s nutritional needs require metabolic assessment.

CMS RVU26DEffective Oct 1, 2026One payment locality8.2K Medicare services in 2024

In Ohio, Medicare pays $48.14 for 94690 in the office.

$48.14Office (non-facility)
Not available in this settingHospital or facility
−8.2%vs the national office rate ($52.44)

Check a contract rate as a % of Medicare · 94690 nationwide

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

We’ll open 94690 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Ohio
  2. What 94690 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 94690 covers

This test measures oxygen uptake while the patient is resting, using indirect calorimetry to estimate resting energy expenditure. It is used when a clinical team needs an individualized measure to support nutritional management, such as for a patient with complex energy needs. Testing is typically performed in a pulmonary or metabolic testing setting by trained staff using gas-analysis equipment, with a clinician interpreting the results.

Report 94690 for the resting indirect-calorimetry service, not for exercise testing or a broader expired-gas analysis. Documentation should identify the clinical reason for measuring resting energy expenditure, confirm that the measurement was obtained at rest, and include the test findings and interpretation. CMS recognizes a global service when billed without a component modifier, or separate professional and technical portions: modifier 26 represents interpretation, while modifier TC represents the equipment and staff portion. Both modifiers are separately priced.

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 Ohio compares for 94690

Across 109 of 109 payment localities, the office rate for 94690 runs from $45.15 in Arkansas to $74.24 in San Benito County, CA. Ohio pays $48.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

94690 in Ohio vs other payment areas
  1. Ohio · this page$48.14
  2. Los Angeles, CA · California$61.36+$13.22
  3. Washington, DC area · District of Columbia$61.44+$13.30
  4. Miami, FL · Florida$55.49+$7.35
  5. Chicago, IL · Illinois$53.57+$5.43
  6. Manhattan, NY · New York$60.99+$12.85
  7. Alaska · Alaska$56.52+$8.38

Other areas in Ohio first, then benchmark localities. Bars start at $0.

Every other payment area

94690 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$45.97—
ArkansasArkansas$45.15—
ArizonaArizona$50.81—
Bakersfield, CACalifornia$56.97—
Chico, CACalifornia$56.91—
El Centro, CACalifornia$56.92—
Fresno, CACalifornia$56.91—
Hanford, CACalifornia$56.91—

94690 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$45.15

$65.57

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
94690 office rate range by state
State / territoryOffice rate rangeLocalities
AK$56.521
AL$45.971
AR$45.151
AZ$50.811
CA$56.91–$74.2429
CO$55.481
CT$56.431
DC$61.441
DE$51.791
FL$50.60–$55.493
GA$47.23–$53.372
GU$58.931
HI$58.931
IA$47.831
ID$48.131
IL$48.51–$54.314
IN$48.491
KS$47.361
KY$46.901
LA$46.73–$49.612
MA$54.96–$62.052
MD$53.00–$61.443
ME$48.23–$51.752
MI$48.22–$51.172
MN$53.401
MO$45.60–$50.073
MS$45.391
MT$52.441
NC$48.891
ND$52.041
NE$48.221
NH$54.381
NJ$57.15–$60.542
NM$48.471
NV$52.381
NY$49.77–$62.505
OH$48.141
OK$47.001
OR$52.04–$57.792
PA$48.35–$54.642
PR$52.971
RI$54.041
SC$48.581
SD$52.001
TN$47.631
TX$47.94–$55.248
UT$49.411
VA$51.40–$61.442
VI$52.971
VT$51.621
WA$54.93–$63.662
WI$49.901
WV$46.251
WY$52.271

See 94690 in every payment locality

How the 94690 rate is calculated

Each of 94690’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 · 94690

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.07

0.07 RVUs× 1.000 GPCI

Practice expense1.48

1.48 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.5700

Conversion factor

$33.4009

Medicare rate

$52.44

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Ohio inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,427

Code
94690
Physician work
0.07
Practice expense
1.48
Malpractice
0.02

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Office calculation for 94690 in Ohio
ComponentRVULocality factorAdjusted
Physician work0.07× 1.0000.0700
Practice expense1.48× 0.9131.3512
Malpractice0.02× 1.0080.0202
Total RVUs1.4414
Conversion factor× 33.4009

Office rate, Ohio$48.14

Office: (0.07 × 1 + 1.48 × 0.913 + 0.02 × 1.008) × $33.4009 = $48.14

Open 94690 in the RVU calculator

Payment rules and modifiers for 94690

The CMS indicators that decide how 94690 is paid alongside other services.

CMS payment indicators · 94690

Metabolic testing, resting oxygen uptake

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

94690 without 26 · national office

$52.44

Metabolic testing, resting oxygen uptake

94690-26 · Professional component

$3.67

Pays only the interpretation and report.

When to use modifier 26

How 94690 has changed in Ohio

94690 · Office / nonfacility

$48.14

Effective 2026-10-01

The base rate is $5.13 higher than on 2025-10-01, moving from $43.01 to $48.14 (11.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $43.01changed to$48.14

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.36 changed to 1.48
    • Practice expense GPCI 0.911 changed to 0.913
    • Malpractice GPCI 1.033 changed to 1.008

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $44.56changed to$43.01

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.37 changed to 1.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $43.84changed to$44.56

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $44.20changed to$43.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.33 changed to 1.37
    • Practice expense GPCI 0.912 changed to 0.911
    • Malpractice GPCI 1.063 changed to 1.033
  5. January 1, 2023

    RVU23A

    $40.78changed to$44.20

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.19 changed to 1.33
    • Practice expense GPCI 0.913 changed to 0.912
    • Malpractice GPCI 1.094 changed to 1.063

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $41.12changed to$40.78

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $47.53changed to$41.12

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.34 changed to 1.19
    • Practice expense GPCI 0.915 changed to 0.913
    • Malpractice GPCI 1.049 changed to 1.094

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $49.51changed to$47.53

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.40 changed to 1.34
    • Practice expense GPCI 0.917 changed to 0.915
    • Malpractice GPCI 1.005 changed to 1.049

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $52.43changed to$49.51

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.49 changed to 1.40

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $48.04changed to$52.43

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.36 changed to 1.49
    • Practice expense GPCI 0.918 changed to 0.917
    • Malpractice GPCI 0.999 changed to 1.005

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $46.60changed to$48.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.32 changed to 1.36
    • Malpractice GPCI 0.993 changed to 0.999

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $46.44changed to$46.60

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.31 changed to 1.32

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $46.21changed to$46.44

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $45.63changed to$46.21

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.28 changed to 1.31
    • Practice expense GPCI 0.923 changed to 0.918
    • Malpractice GPCI 1.117 changed to 0.993

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $48.33changed to$45.63

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.43 changed to 1.28
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.240 changed to 1.117

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $48.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$48.14Not available in this settingRVU26D
2026-07-01$48.14Not available in this settingRVU26C
2026-04-01$48.14Not available in this settingRVU26B
2026-01-01$48.14Not available in this settingRVU26A
2025-10-01$43.01Not available in this settingRVU25D
2025-07-01$43.01Not available in this settingRVU25C
2025-04-01$43.01Not available in this settingRVU25B
2025-01-01$43.01Not available in this settingRVU25A
2024-10-01$44.56Not available in this settingRVU24D
2024-07-01$44.56Not available in this settingRVU24C
2024-04-01$44.56Not available in this settingRVU24B
2024-03-09$44.56Not available in this settingRVU24AR
2024-01-01$43.84Not available in this settingRVU24A
2023-10-01$44.20Not available in this settingRVU23D
2023-07-01$44.20Not available in this settingRVU23C
2023-04-01$44.20Not available in this settingRVU23B
2023-01-01$44.20Not available in this settingRVU23A
2022-10-01$40.78Not available in this settingRVU22D
2022-07-01$40.78Not available in this settingRVU22C
2022-04-01$40.78Not available in this settingRVU22B
2022-01-01$40.78Not available in this settingRVU22A
2021-10-01$41.12Not available in this settingRVU21D
2021-07-01$41.12Not available in this settingRVU21C
2021-04-01$41.12Not available in this settingRVU21B
2021-01-01$41.12Not available in this settingRVU21A
2020-10-01$47.53Not available in this settingRVU20D
2020-07-01$47.53Not available in this settingRVU20C
2020-04-01$47.53Not available in this settingRVU20B
2020-01-01$47.53Not available in this settingRVU20A
2019-10-01$49.51Not available in this settingRVU19D
2019-07-01$49.51Not available in this settingRVU19C
2019-04-01$49.51Not available in this settingRVU19B
2019-01-01$49.51Not available in this settingRVU19A
2018-10-01$52.43Not available in this settingRVU18D
2018-07-01$52.43Not available in this settingRVU18C
2018-04-01$52.43Not available in this settingRVU18B
2018-01-01$52.43Not available in this settingRVU18AR1
2017-10-01$48.04Not available in this settingRVU17D
2017-07-01$48.04Not available in this settingRVU17C
2017-04-01$48.04Not available in this settingRVU17B
2017-01-01$48.04Not available in this settingRVU17A
2016-10-01$46.60Not available in this settingRVU16D
2016-07-01$46.60Not available in this settingRVU16C
2016-04-01$46.60Not available in this settingRVU16B
2016-01-01$46.60Not available in this settingRVU16A
2015-10-01$46.44Not available in this settingRVU15D
2015-07-01$46.44Not available in this settingRVU15C
2015-04-01$46.21Not available in this settingRVU15B
2015-01-01$46.21Not available in this settingRVU15A
2014-10-01$45.63Not available in this settingRVU14D
2014-07-01$45.63Not available in this settingRVU14C
2014-04-01$45.63Not available in this settingRVU14B
2014-01-01$45.63Not available in this settingRVU14A
2013-10-01$48.33Not available in this settingRVU13D
2013-07-01$48.33Not available in this settingRVU13C
2013-04-01$48.33Not available in this settingRVU13B
2013-01-01$48.33Not available in this settingRVU13AR

Price 94690 for an earlier date of service

Where the Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Ada
  • Adamsville
  • Addyston
  • Adelphi
  • Adena
  • Ai
  • Akron

Browse all communities in Ohio

94690 billing questions

When should 94690 be chosen instead of 94680?

Use 94690 for oxygen uptake measured at rest by indirect calorimetry. Code 94680 describes expired-gas analysis with a broader set of measurements.

How does 94690 differ from 94681?

94690 is specifically for resting oxygen uptake by indirect calorimetry. Code 94681 includes expired-gas analysis with calculation of the respiratory quotient.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion. Billing without either modifier represents the global service.

What documentation supports reporting 94690?

Document the clinical reason for measuring resting energy expenditure, that the patient was tested at rest, the measured findings, and the interpretation.

Is this code for a pulmonary exercise test?

No. 94690 reports resting oxygen uptake by indirect calorimetry; exercise-based pulmonary or cardiopulmonary testing is reported with a different code.

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
RVUs for 94690PPRRVU2026_Oct_nonQPP.csv, line 12,427 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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