CPT 94003: Ventilator managementMedicare rate & RVUs

Medicare pays $59.12 for 94003 nationally in a facility.

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

What 94003 covers

This service covers a physician’s subsequent-day management of a patient receiving assisted or controlled ventilation in a hospital inpatient or observation setting. The clinician evaluates the patient’s ventilatory status and directs ongoing ventilator care, including assessing the response to support and deciding whether management changes are needed. It is distinct from the initial-day service and from ventilator management in a nursing facility or at home. Hospital physicians caring for ventilated patients commonly report it; a respiratory therapist’s equipment adjustment alone does not describe the physician service.

Report 94003 for a later service day when the physician provides and documents ventilator management; use 94002 for the initial day. The record should support the patient’s ventilator-dependent status, relevant respiratory findings, clinical assessment, and management decisions for that date. Do not select the code solely because the patient remains connected to a ventilator or because settings are recorded without documented clinician management. The supplied CMS facts list no code-specific payment rules.

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 94003 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

94003 rates by state

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

How the 94003 rate is calculated

Each of 94003’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 94003

94003 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.

94003 compared with similar codes

How to choose

94002Ventilator management

Choose 94002 for the initial day of hospital inpatient or observation ventilator management; 94003 is for a subsequent service day.

94004Ventilation management

Choose 94004 when the ventilator-management service is furnished in a nursing facility, rather than in hospital inpatient or observation care.

94005Home vent mgmt supervision

Choose 94005 for home ventilator-management supervision; 94003 describes subsequent-day management in a hospital inpatient or observation setting.

Codes related to 94003

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