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Billing code 94011: Infant spirometryMedicare rate & RVUs

Reports specialized spirometry for a child age 2 years or younger, measuring vital capacity and expiratory flow with infant-appropriate testing methods.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $71.81 for 94011 nationally in a facility.

Medicare rate · 94011

Infant spirometry

Swap in your local Medicare rate.

Work RVUs
1.71
Total RVUs
2.15
Global days
XXX

National rate · 2026

$71.81

Facility setting, before claim adjustments.

See every locality for 94011 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 94011 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 94011 covers

94011 represents pulmonary function testing adapted for infants who cannot reliably perform routine spirometry maneuvers. The test produces a graphic record and measurements of vital capacity and expiratory flow using techniques and equipment suited to a child age 2 or younger. It is typically performed by a pulmonary function laboratory or pediatric pulmonary service in an outpatient clinic or hospital when evaluating respiratory symptoms such as wheezing or suspected obstructive disease.

Choose this code based on the patient’s age and the infant spirometry performed, not simply because a young child had a breathing assessment. Document the indication, the child’s age, the testing method, and the resulting curves or measurements. Report additional infant lung-volume or enhanced spirometry services only when those distinct procedures are performed and documented. CMS values the service through physician-work, practice-expense, and malpractice inputs; use the applicable fee schedule rate for the claim’s payment context.

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 94011 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

94011 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$69.05
Alaska*Unavailable$99.78
ArizonaUnavailable$71.02
ArkansasUnavailable$68.71
AtlantaUnavailable$72.77
AustinUnavailable$72.26
BakersfieldUnavailable$72.84
Baltimore/Surr. CntysUnavailable$74.29
BeaumontUnavailable$70.55
BrazoriaUnavailable$71.50

94011 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
94011 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 94011 rate is calculated

Each of 94011’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 · 94011

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.71Practice expense 0.35Malpractice 0.09

2.1500 adjusted RVUs×$33.4009 conversion factor=$71.81

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 94011

94011 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.

Place of service · 94011

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

Non-facility (office) rate · national

—

94011 isn’t priced in this setting.

94011 compared with similar codes

Compare codes

94011 vs 94010 vs 94012 vs 94013: national Medicare rates

Swap in your local Medicare rate.

  • 94011
    Infant spirometry · 1.71 wRVU
    —
  • 94010
    Spirometry · 0.17 wRVU
    $29.73
  • 94012
    Infant spirometry · 2.78 wRVU
    —
  • 94013
    Lung-volume test · 0.4 wRVU
    —

How to choose

94010Spirometry
Choose 94011 for infant-specific spirometry in a child age 2 or younger. Use 94010 for general spirometry when the patient can perform standard maneuvers.
94012Infant spirometry
Both codes concern infant spirometry, but 94012 includes additional flow-volume loop or bronchodilator-responsiveness testing.
94013Lung-volume test
94011 measures infant spirometry, including vital capacity and expiratory flow; 94013 is for distinct infant lung-volume measurements.

Codes related to 94011

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

Codes related to 94011
CodeHow it relatesNational office range
Used instead
94010SpirometryGeneral spirometry for patients able to perform standard maneuvers rather than infant-specific testing.$26.11–$40.38
94060Bronchodilator spirometrySpirometry with bronchodilator responsiveness for patients able to perform standard maneuvers.$38.06–$59.68
Same family
94012Infant spirometryInfant spirometry with additional flow-volume loop or bronchodilator-responsiveness testing.No office rate
Often billed with
94013Lung-volume testReports distinct infant lung-volume measurements that may accompany an infant pulmonary-function assessment.No office rate

94011 billing questions

How is 94011 different from 94010?

94011 is for infant spirometry in a child age 2 or younger, using testing suited to the infant. 94010 is the general spirometry code for patients who can perform standard spirometry maneuvers.

When should 94012 be used instead?

Use 94012 when the infant spirometry service includes the additional flow-volume loop or bronchodilator-responsiveness testing represented by that code. Do not select it solely because the patient is an infant.

Are the graphic record and flow measurements separate services?

The graphic record and vital-capacity and expiratory-flow measurements are elements of 94011. They are not separately reported as individual services when they are part of the same infant spirometry test.

What documentation supports reporting 94011?

Document the child’s age, the clinical reason for testing, the infant-appropriate spirometry performed, and the resulting measurements or tracing. The record should distinguish any separately performed lung-volume or enhanced spirometry testing.

Is 94011 reported once per maneuver?

No. Report the infant spirometry service, not each individual maneuver or tracing.

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 94011PPRRVU2026_Oct_nonQPP.csv, line 12,367 (RVU26D)

Open CMS sourceHow we calculate rates

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