Billing code 94200: Lung function testMedicare rate & RVUs

Medicare pays $16.37 for 94200 nationally in the office. Local office rates run $14.06–$22.44.

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

What 94200 covers

This pulmonary function test measures the amount of air a patient can move with rapid, sustained breathing over a brief testing period. The result is used to assess ventilatory capacity and may help characterize respiratory impairment. A respiratory therapist or pulmonary function technician typically performs the maneuver in a pulmonary function laboratory or clinic, with a physician interpreting the results.

Select this code when the documented service is a maximum voluntary ventilation measurement, rather than spirometry, lung-volume measurement, or another pulmonary function test. The record should identify the test performed and include its results and interpretation. CMS recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier when billing the global service, which includes both components.

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 94200 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

94200 rates by state

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

How the 94200 rate is calculated

Each of 94200’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 94200

The CMS indicators that decide how 94200 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

94200 compared with similar codes

How to choose

94010Spirometry

Use 94010 for spirometry measurements of airflow and lung volume during forced breathing maneuvers. Use 94200 when the service measures maximum voluntary ventilation through sustained rapid breathing.

94150Vital capacity test

94150 measures vital capacity, the volume exhaled after a maximal inhalation. Code 94200 represents a separate maximum voluntary ventilation measurement.

94726Body plethysmography

94726 measures lung volumes, commonly using body plethysmography. Code 94200 measures ventilatory capacity during rapid, sustained breathing.

Codes related to 94200

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