Billing code 94016: Spirometry reviewMedicare rate & RVUs

Medicare pays $24.72 for 94016 nationally in the office and $24.72 in a hospital or facility. Local office rates run $23.40–$33.39.

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

What 94016 covers

This service covers a physician’s or other qualified health care professional’s review of spirometry recordings initiated by the patient, interpretation of the results, and a report. Patients typically make recordings with a spirometer outside the clinic as part of monitoring lung function over time; the clinician reviews the submitted data rather than performing a single office spirometry session. Pulmonary and primary care practices may use this service when following patients whose care includes home spirometry monitoring.

Report 94016 for the professional review and interpretation associated with a 30-day period, not for each individual recording. Documentation should identify the monitoring period, show that patient-initiated spirometry data were reviewed, and include the clinician’s interpretation and report. CMS classifies 94016 as professional-component-only; the technical portion is represented separately. When the recording service is reported under a separate technical code, keep the interpretation distinct from the equipment, recording, and data-handling work.

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 94016 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

94016 rates by state

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

How the 94016 rate is calculated

Each of 94016’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 94016

The CMS indicators that decide how 94016 is paid alongside other services.

94016 compared with similar codes

How to choose

94014Remote spirometry

94014 covers the technical recording service. Use 94016 for the clinician’s review, interpretation, and report.

94015Remote spirometry

94015 represents the broader patient-initiated spirometry service, while 94016 is limited to professional interpretation and reporting.

94010Spirometry

94010 is for a spirometry testing session; 94016 is for clinician review of patient-initiated recordings collected during a monitoring period.

Codes related to 94016

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