CPT code 94690: Metabolic testing, resting oxygen uptake2026 Medicare rate & RVUs in Puerto Rico
Measures oxygen uptake at rest by indirect calorimetry to estimate resting energy expenditure when a patient’s nutritional needs require metabolic assessment.
In Puerto Rico, Medicare pays $52.97 for 94690 in the office.
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.
On this page 11 sections
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 Puerto Rico 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. Puerto Rico pays $52.97. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$52.97
- Los Angeles, CA · California$61.36+$8.39
- Washington, DC area · District of Columbia$61.44+$8.47
- Miami, FL · Florida$55.49+$2.52
- Chicago, IL · Illinois$53.57+$0.60
- Manhattan, NY · New York$60.99+$8.02
- Alaska · Alaska$56.52+$3.55
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $56.91 | — |
| Merced, CACalifornia | $56.91 | — |
| Modesto, CACalifornia | $56.91 | — |
| Napa, CACalifornia | $67.98 | — |
| Oxnard, CACalifornia | $61.25 | — |
| Redding, CACalifornia | $56.91 | — |
| Rest of CaliforniaCalifornia | $56.91 | — |
| Riverside, CACalifornia | $57.13 | — |
| Sacramento, CACalifornia | $60.27 | — |
| Salinas, CACalifornia | $60.06 | — |
| San Diego, CACalifornia | $61.89 | — |
| Marin County, CACalifornia | $72.57 | — |
| San Francisco, CACalifornia | $72.55 | — |
| San Benito County, CACalifornia | $74.24 | — |
| Santa Clara County, CACalifornia | $74.14 | — |
| San Luis Obispo, CACalifornia | $59.04 | — |
| Santa Cruz, CACalifornia | $62.81 | — |
| Santa Maria, CACalifornia | $60.40 | — |
| Santa Rosa, CACalifornia | $63.47 | — |
| Stockton, CACalifornia | $56.91 | — |
| Vallejo, CACalifornia | $67.95 | — |
| Visalia, CACalifornia | $56.91 | — |
| Yuba City, CACalifornia | $56.91 | — |
| ColoradoColorado | $55.48 | — |
| ConnecticutConnecticut | $56.43 | — |
| DelawareDelaware | $51.79 | — |
| Fort Lauderdale, FLFlorida | $53.62 | — |
| Rest of FloridaFlorida | $50.60 | — |
| Atlanta, GAGeorgia | $53.37 | — |
| Rest of GeorgiaGeorgia | $47.23 | — |
| Hawaii, Guam, HIHawaii | $58.93 | — |
| IowaIowa | $47.83 | — |
| IdahoIdaho | $48.13 | — |
| East St. Louis, ILIllinois | $49.16 | — |
| Rest of IllinoisIllinois | $48.51 | — |
| Suburban Chicago, ILIllinois | $54.31 | — |
| IndianaIndiana | $48.49 | — |
| KansasKansas | $47.36 | — |
| KentuckyKentucky | $46.90 | — |
| New Orleans, LALouisiana | $49.61 | — |
| Rest of LouisianaLouisiana | $46.73 | — |
| Metropolitan Boston, MAMassachusetts | $62.05 | — |
| Rest of MassachusettsMassachusetts | $54.96 | — |
| Baltimore area, MDMaryland | $56.24 | — |
| Rest of MarylandMaryland | $53.00 | — |
| Rest of MaineMaine | $48.23 | — |
| Southern Maine, MEMaine | $51.75 | — |
| Detroit, MIMichigan | $51.17 | — |
| Rest of MichiganMichigan | $48.22 | — |
| MinnesotaMinnesota | $53.40 | — |
| Metropolitan Kansas City, MOMissouri | $49.41 | — |
| Metropolitan St. Louis, MOMissouri | $50.07 | — |
| Rest of MissouriMissouri | $45.60 | — |
| MississippiMississippi | $45.39 | — |
| MontanaMontana | $52.44 | — |
| North CarolinaNorth Carolina | $48.89 | — |
| North DakotaNorth Dakota | $52.04 | — |
| NebraskaNebraska | $48.22 | — |
| New HampshireNew Hampshire | $54.38 | — |
| Northern New JerseyNew Jersey | $60.54 | — |
| Rest of New JerseyNew Jersey | $57.15 | — |
| New MexicoNew Mexico | $48.47 | — |
| NevadaNevada | $52.38 | — |
| NYC suburbs and Long Island, NYNew York | $62.50 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $57.38 | — |
| Queens, NYNew York | $61.88 | — |
| Rest of New YorkNew York | $49.77 | — |
| OhioOhio | $48.14 | — |
| OklahomaOklahoma | $47.00 | — |
| Portland, OROregon | $57.79 | — |
| Rest of OregonOregon | $52.04 | — |
| Metropolitan Philadelphia, PAPennsylvania | $54.64 | — |
| Rest of PennsylvaniaPennsylvania | $48.35 | — |
| Rhode IslandRhode Island | $54.04 | — |
| South CarolinaSouth Carolina | $48.58 | — |
| South DakotaSouth Dakota | $52.00 | — |
| TennesseeTennessee | $47.63 | — |
| Austin, TXTexas | $55.24 | — |
| Beaumont, TXTexas | $47.94 | — |
| Brazoria, TXTexas | $51.87 | — |
| Dallas, TXTexas | $52.17 | — |
| Fort Worth, TXTexas | $51.68 | — |
| Galveston, TXTexas | $52.00 | — |
| Houston, TXTexas | $52.36 | — |
| Rest of TexasTexas | $49.85 | — |
| UtahUtah | $49.41 | — |
| VirginiaVirginia | $51.40 | — |
| Virgin Islands, VIUnited States Virgin Islands | $52.97 | — |
| VermontVermont | $51.62 | — |
| Rest of WashingtonWashington | $54.93 | — |
| King County, WAWashington | $63.66 | — |
| WisconsinWisconsin | $49.90 | — |
| West VirginiaWest Virginia | $46.25 | — |
| WyomingWyoming | $52.27 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $56.52 | 1 |
| AL | $45.97 | 1 |
| AR | $45.15 | 1 |
| AZ | $50.81 | 1 |
| CA | $56.91–$74.24 | 29 |
| CO | $55.48 | 1 |
| CT | $56.43 | 1 |
| DC | $61.44 | 1 |
| DE | $51.79 | 1 |
| FL | $50.60–$55.49 | 3 |
| GA | $47.23–$53.37 | 2 |
| GU | $58.93 | 1 |
| HI | $58.93 | 1 |
| IA | $47.83 | 1 |
| ID | $48.13 | 1 |
| IL | $48.51–$54.31 | 4 |
| IN | $48.49 | 1 |
| KS | $47.36 | 1 |
| KY | $46.90 | 1 |
| LA | $46.73–$49.61 | 2 |
| MA | $54.96–$62.05 | 2 |
| MD | $53.00–$61.44 | 3 |
| ME | $48.23–$51.75 | 2 |
| MI | $48.22–$51.17 | 2 |
| MN | $53.40 | 1 |
| MO | $45.60–$50.07 | 3 |
| MS | $45.39 | 1 |
| MT | $52.44 | 1 |
| NC | $48.89 | 1 |
| ND | $52.04 | 1 |
| NE | $48.22 | 1 |
| NH | $54.38 | 1 |
| NJ | $57.15–$60.54 | 2 |
| NM | $48.47 | 1 |
| NV | $52.38 | 1 |
| NY | $49.77–$62.50 | 5 |
| OH | $48.14 | 1 |
| OK | $47.00 | 1 |
| OR | $52.04–$57.79 | 2 |
| PA | $48.35–$54.64 | 2 |
| PR | $52.97 | 1 |
| RI | $54.04 | 1 |
| SC | $48.58 | 1 |
| SD | $52.00 | 1 |
| TN | $47.63 | 1 |
| TX | $47.94–$55.24 | 8 |
| UT | $49.41 | 1 |
| VA | $51.40–$61.44 | 2 |
| VI | $52.97 | 1 |
| VT | $51.62 | 1 |
| WA | $54.93–$63.66 | 2 |
| WI | $49.90 | 1 |
| WV | $46.25 | 1 |
| WY | $52.27 | 1 |
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
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 Puerto Rico 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
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.07 | × 1.000 | 0.0700 |
| Practice expense | 1.48 | × 1.011 | 1.4963 |
| Malpractice | 0.02 | × 0.985 | 0.0197 |
| Total RVUs | 1.5860 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$52.97
Office: (0.07 × 1 + 1.48 × 1.011 + 0.02 × 0.985) × $33.4009 = $52.97
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
| 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
94690 without 26 · national office
$52.44
Metabolic testing, resting oxygen uptake
94690-26 · Professional component
$3.67
Pays only the interpretation and report.
How 94690 has changed in Puerto Rico
94690 · Office / nonfacility
$52.97
Effective 2026-10-01
The base rate is $5.77 higher than on 2025-10-01, moving from $47.20 to $52.97 (12.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$47.20changed to$52.97
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.36 changed to 1.48
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$48.91changed to$47.20
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.37 changed to 1.36
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$48.11changed to$48.91
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$48.47changed to$48.11
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.33 changed to 1.37
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$48.12changed to$48.47
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$44.62changed to$48.12
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.19 changed to 1.33
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$44.99changed to$44.62
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$51.99changed to$44.99
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.34 changed to 1.19
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$54.04changed to$51.99
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.40 changed to 1.34
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$57.25changed to$54.04
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.49 changed to 1.40
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$44.75changed to$57.25
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.36 changed to 1.49
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$36.04changed to$44.75
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.32 changed to 1.36
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$35.91changed to$36.04
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.31 changed to 1.32
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$35.73changed to$35.91
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$34.43changed to$35.73
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.28 changed to 1.31
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$35.54changed to$34.43
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.43 changed to 1.28
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $35.54
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $52.97 | Not available in this setting | RVU26D |
| 2026-07-01 | $52.97 | Not available in this setting | RVU26C |
| 2026-04-01 | $52.97 | Not available in this setting | RVU26B |
| 2026-01-01 | $52.97 | Not available in this setting | RVU26A |
| 2025-10-01 | $47.20 | Not available in this setting | RVU25D |
| 2025-07-01 | $47.20 | Not available in this setting | RVU25C |
| 2025-04-01 | $47.20 | Not available in this setting | RVU25B |
| 2025-01-01 | $47.20 | Not available in this setting | RVU25A |
| 2024-10-01 | $48.91 | Not available in this setting | RVU24D |
| 2024-07-01 | $48.91 | Not available in this setting | RVU24C |
| 2024-04-01 | $48.91 | Not available in this setting | RVU24B |
| 2024-03-09 | $48.91 | Not available in this setting | RVU24AR |
| 2024-01-01 | $48.11 | Not available in this setting | RVU24A |
| 2023-10-01 | $48.47 | Not available in this setting | RVU23D |
| 2023-07-01 | $48.12 | Not available in this setting | RVU23C |
| 2023-04-01 | $48.12 | Not available in this setting | RVU23B |
| 2023-01-01 | $48.12 | Not available in this setting | RVU23A |
| 2022-10-01 | $44.62 | Not available in this setting | RVU22D |
| 2022-07-01 | $44.62 | Not available in this setting | RVU22C |
| 2022-04-01 | $44.62 | Not available in this setting | RVU22B |
| 2022-01-01 | $44.62 | Not available in this setting | RVU22A |
| 2021-10-01 | $44.99 | Not available in this setting | RVU21D |
| 2021-07-01 | $44.99 | Not available in this setting | RVU21C |
| 2021-04-01 | $44.99 | Not available in this setting | RVU21B |
| 2021-01-01 | $44.99 | Not available in this setting | RVU21A |
| 2020-10-01 | $51.99 | Not available in this setting | RVU20D |
| 2020-07-01 | $51.99 | Not available in this setting | RVU20C |
| 2020-04-01 | $51.99 | Not available in this setting | RVU20B |
| 2020-01-01 | $51.99 | Not available in this setting | RVU20A |
| 2019-10-01 | $54.04 | Not available in this setting | RVU19D |
| 2019-07-01 | $54.04 | Not available in this setting | RVU19C |
| 2019-04-01 | $54.04 | Not available in this setting | RVU19B |
| 2019-01-01 | $54.04 | Not available in this setting | RVU19A |
| 2018-10-01 | $57.25 | Not available in this setting | RVU18D |
| 2018-07-01 | $57.25 | Not available in this setting | RVU18C |
| 2018-04-01 | $57.25 | Not available in this setting | RVU18B |
| 2018-01-01 | $57.25 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $44.75 | Not available in this setting | RVU17D |
| 2017-07-01 | $44.75 | Not available in this setting | RVU17C |
| 2017-04-01 | $44.75 | Not available in this setting | RVU17B |
| 2017-01-01 | $44.75 | Not available in this setting | RVU17A |
| 2016-10-01 | $36.04 | Not available in this setting | RVU16D |
| 2016-07-01 | $36.04 | Not available in this setting | RVU16C |
| 2016-04-01 | $36.04 | Not available in this setting | RVU16B |
| 2016-01-01 | $36.04 | Not available in this setting | RVU16A |
| 2015-10-01 | $35.91 | Not available in this setting | RVU15D |
| 2015-07-01 | $35.91 | Not available in this setting | RVU15C |
| 2015-04-01 | $35.73 | Not available in this setting | RVU15B |
| 2015-01-01 | $35.73 | Not available in this setting | RVU15A |
| 2014-10-01 | $34.43 | Not available in this setting | RVU14D |
| 2014-07-01 | $34.43 | Not available in this setting | RVU14C |
| 2014-04-01 | $34.43 | Not available in this setting | RVU14B |
| 2014-01-01 | $34.43 | Not available in this setting | RVU14A |
| 2013-10-01 | $35.54 | Not available in this setting | RVU13D |
| 2013-07-01 | $35.54 | Not available in this setting | RVU13C |
| 2013-04-01 | $35.54 | Not available in this setting | RVU13B |
| 2013-01-01 | $35.54 | Not available in this setting | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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
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