CPT code 94727: Lung volumes, gas dilution or washout2026 Medicare rate & RVUs in Delaware

Measures lung volumes using gas dilution or washout, typically in a pulmonary function laboratory when a clinician needs lung-volume data.

CMS RVU26DEffective Oct 1, 2026One payment locality249.3K Medicare services in 2024

In Delaware, Medicare pays $49.25 for 94727 in the office.

$49.25Office (non-facility)
Not available in this settingHospital or facility
−1.0%vs the national office rate ($49.77)

Check a contract rate as a % of Medicare · 94727 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 94727 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 94727 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 94727 covers

Code 94727 covers lung-volume measurement by gas dilution or washout, commonly using helium dilution or nitrogen washout in a pulmonary function laboratory. The test estimates functional residual capacity and derives residual volume and total lung capacity; respiratory therapists typically conduct the maneuver, with a clinician interpreting the results. Because the method measures gas that reaches communicating airways, its lung-volume results can differ from body plethysmography when air trapping is present.

Select 94727 when the documented method is gas dilution or washout, rather than the plethysmographic method reported with 94726. The record should identify the testing method, include the resulting lung-volume measurements, and support the interpreting clinician’s conclusions. CMS recognizes separately priced professional and technical components: use modifier 26 for interpretation, modifier TC for equipment and staff, or report without either modifier for the global service. Report the test service rather than separate units for each calculated volume.

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 Delaware compares for 94727

Across 109 of 109 payment localities, the office rate for 94727 runs from $43.70 in Arkansas to $68.39 in San Benito County, CA. Delaware pays $49.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

94727 in Delaware vs other payment areas
  1. Delaware · this page$49.25
  2. Los Angeles, CA · California$57.34+$8.09
  3. Washington, DC area · District of Columbia$57.55+$8.30
  4. Miami, FL · Florida$52.46+$3.21
  5. Chicago, IL · Illinois$50.89+$1.64
  6. Manhattan, NY · New York$57.29+$8.04
  7. Alaska · Alaska$56.29+$7.04

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

Every other payment area

94727 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$44.38—
ArkansasArkansas$43.70—
ArizonaArizona$48.41—
Bakersfield, CACalifornia$53.58—
Chico, CACalifornia$53.51—
El Centro, CACalifornia$53.51—
Fresno, CACalifornia$53.51—
Hanford, CACalifornia$53.51—

94727 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.

$43.70

$60.95

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

View every state and territory as a table
94727 office rate range by state
State / territoryOffice rate rangeLocalities
AK$56.291
AL$44.381
AR$43.701
AZ$48.411
CA$53.51–$68.3929
CO$52.331
CT$53.211
DC$57.551
DE$49.251
FL$48.31–$52.463
GA$45.49–$50.582
GU$55.071
HI$55.071
IA$45.901
ID$46.161
IL$46.60–$51.444
IN$46.451
KS$45.521
KY$45.191
LA$45.05–$47.452
MA$51.93–$57.942
MD$50.29–$57.553
ME$46.25–$49.152
MI$46.31–$48.802
MN$50.481
MO$44.13–$47.813
MS$43.931
MT$49.771
NC$46.801
ND$49.371
NE$46.211
NH$51.351
NJ$53.92–$56.862
NM$46.521
NV$49.701
NY$47.53–$58.585
OH$46.231
OK$45.261
OR$49.41–$54.252
PA$46.39–$51.722
PR$50.211
RI$51.201
SC$46.571
SD$49.321
TN$45.751
TX$46.05–$52.078
UT$47.251
VA$48.88–$57.552
VI$50.211
VT$49.031
WA$51.88–$59.312
WI$47.591
WV$44.721
WY$49.591

See 94727 in every payment locality

How the 94727 rate is calculated

Each of 94727’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 · 94727

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.25

0.25 RVUs× 1.000 GPCI

Practice expense1.22

1.22 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.4900

Conversion factor

$33.4009

Medicare rate

$49.77

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

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,433

Code
94727
Physician work
0.25
Practice expense
1.22
Malpractice
0.02

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 94727 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.25× 1.0050.2512
Practice expense1.22× 0.9881.2054
Malpractice0.02× 0.8990.0180
Total RVUs1.4746
Conversion factor× 33.4009

Office rate, Delaware$49.25

Office: (0.25 × 1.005 + 1.22 × 0.988 + 0.02 × 0.899) × $33.4009 = $49.25

Open 94727 in the RVU calculator

Payment rules and modifiers for 94727

The CMS indicators that decide how 94727 is paid alongside other services.

CMS payment indicators · 94727

Lung volumes, gas dilution or washout

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

94727 without 26 · national office

$49.77

Lung volumes, gas dilution or washout

94727-26 · Professional component

$12.02

Pays only the interpretation and report.

When to use modifier 26

How 94727 has changed in Delaware

94727 · Office / nonfacility

$49.25

Effective 2026-10-01

The base rate is $5.82 higher than on 2025-10-01, moving from $43.43 to $49.25 (13.4%).

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

    $43.43changed to$49.25

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.26 changed to 0.25
    • Practice expense RVU 1.07 changed to 1.22
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $44.37changed to$43.43

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.06 changed to 1.07

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $43.64changed to$44.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $44.31changed to$43.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.02 changed to 1.06
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949
  5. January 1, 2023

    RVU23A

    $45.41changed to$44.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.01 changed to 1.02
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $45.43changed to$45.41

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.00 changed to 1.01

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $45.18changed to$45.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.95 changed to 1.00
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $45.13changed to$45.18

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $45.81changed to$45.13

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.97 changed to 0.95

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $43.69changed to$45.81

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.91 changed to 0.97
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $43.79changed to$43.69

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $43.95changed to$43.79

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $43.73changed to$43.95

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $43.52changed to$43.73

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.90 changed to 0.91
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $49.19changed to$43.52

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.12 changed to 0.90
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $49.19

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$49.25Not available in this settingRVU26D
2026-07-01$49.25Not available in this settingRVU26C
2026-04-01$49.25Not available in this settingRVU26B
2026-01-01$49.25Not available in this settingRVU26A
2025-10-01$43.43Not available in this settingRVU25D
2025-07-01$43.43Not available in this settingRVU25C
2025-04-01$43.43Not available in this settingRVU25B
2025-01-01$43.43Not available in this settingRVU25A
2024-10-01$44.37Not available in this settingRVU24D
2024-07-01$44.37Not available in this settingRVU24C
2024-04-01$44.37Not available in this settingRVU24B
2024-03-09$44.37Not available in this settingRVU24AR
2024-01-01$43.64Not available in this settingRVU24A
2023-10-01$44.31Not available in this settingRVU23D
2023-07-01$44.31Not available in this settingRVU23C
2023-04-01$44.31Not available in this settingRVU23B
2023-01-01$44.31Not available in this settingRVU23A
2022-10-01$45.41Not available in this settingRVU22D
2022-07-01$45.41Not available in this settingRVU22C
2022-04-01$45.41Not available in this settingRVU22B
2022-01-01$45.41Not available in this settingRVU22A
2021-10-01$45.43Not available in this settingRVU21D
2021-07-01$45.43Not available in this settingRVU21C
2021-04-01$45.43Not available in this settingRVU21B
2021-01-01$45.43Not available in this settingRVU21A
2020-10-01$45.18Not available in this settingRVU20D
2020-07-01$45.18Not available in this settingRVU20C
2020-04-01$45.18Not available in this settingRVU20B
2020-01-01$45.18Not available in this settingRVU20A
2019-10-01$45.13Not available in this settingRVU19D
2019-07-01$45.13Not available in this settingRVU19C
2019-04-01$45.13Not available in this settingRVU19B
2019-01-01$45.13Not available in this settingRVU19A
2018-10-01$45.81Not available in this settingRVU18D
2018-07-01$45.81Not available in this settingRVU18C
2018-04-01$45.81Not available in this settingRVU18B
2018-01-01$45.81Not available in this settingRVU18AR1
2017-10-01$43.69Not available in this settingRVU17D
2017-07-01$43.69Not available in this settingRVU17C
2017-04-01$43.69Not available in this settingRVU17B
2017-01-01$43.69Not available in this settingRVU17A
2016-10-01$43.79Not available in this settingRVU16D
2016-07-01$43.79Not available in this settingRVU16C
2016-04-01$43.79Not available in this settingRVU16B
2016-01-01$43.79Not available in this settingRVU16A
2015-10-01$43.95Not available in this settingRVU15D
2015-07-01$43.95Not available in this settingRVU15C
2015-04-01$43.73Not available in this settingRVU15B
2015-01-01$43.73Not available in this settingRVU15A
2014-10-01$43.52Not available in this settingRVU14D
2014-07-01$43.52Not available in this settingRVU14C
2014-04-01$43.52Not available in this settingRVU14B
2014-01-01$43.52Not available in this settingRVU14A
2013-10-01$49.19Not available in this settingRVU13D
2013-07-01$49.19Not available in this settingRVU13C
2013-04-01$49.19Not available in this settingRVU13B
2013-01-01$49.19Not available in this settingRVU13AR

Price 94727 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

94727 billing questions

How does 94727 differ from 94726?

Code 94727 is for lung volumes measured by gas dilution or washout. Use 94726 for the plethysmographic method.

Can 94727 be reported with a diffusion-capacity test?

Yes. A gas-dilution lung-volume test and a diffusion-capacity test measure different pulmonary functions and may be performed during the same testing encounter.

Which modifiers identify the components?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.

Should each measured lung volume be reported as a separate unit?

No. Report the gas-dilution or washout test service, not separate units for functional residual capacity, residual volume, and total lung capacity.

What documentation supports 94727?

Document the gas-dilution or washout method, the resulting lung-volume measurements, and the clinician’s interpretation. The method helps distinguish this service from plethysmography.

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 94727PPRRVU2026_Oct_nonQPP.csv, line 12,433 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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