Billing code 94452: Altitude simulation testMedicare rate & RVUs
Reports simulated-altitude breathing assessment with interpretation and a written report, typically used to evaluate oxygenation before air travel in a patient with lung disease.
Medicare pays $57.45 for 94452 nationally in the office. Local office rates run $50.53–$78.91.
Medicare rate · 94452
Altitude simulation test
Swap in your local Medicare rate.
- Work RVUs
- 0.3
- Total RVUs
- 1.72
- Global days
- XXX
National rate · 2026
$57.45
Office setting, before claim adjustments.
See every locality for 94452 → · 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
What 94452 covers
A high-altitude simulation test assesses whether a patient maintains adequate oxygenation while breathing a reduced-oxygen mixture that approximates an aircraft cabin environment. A pulmonary laboratory or respiratory therapist typically administers the test and monitors oxygen saturation. A physician or other qualified health care professional interprets the findings and prepares the report. The test may be requested before air travel for a patient with chronic lung disease whose oxygen needs at cabin altitude are uncertain.
Report 94452 for the simulated-altitude assessment with interpretation and report. The record should identify the simulated exposure, the patient's oxygenation during testing, and the interpreting clinician's findings. If supplemental oxygen is titrated during the assessment, consider the distinct service described by 94453. Medicare recognizes a professional component for the interpretation, reported with modifier 26, and a technical component for the equipment and staff, reported with modifier TC. Billing 94452 without either modifier represents the complete service.
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 94452 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$50.53 to $78.91
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $51.31 | Unavailable |
| Alaska* | $65.20 | Unavailable |
| Arizona | $55.90 | Unavailable |
| Arkansas | $50.53 | Unavailable |
| Atlanta | $58.36 | Unavailable |
| Austin | $60.11 | Unavailable |
| Bakersfield | $61.87 | Unavailable |
| Baltimore/Surr. Cntys | $61.18 | Unavailable |
| Beaumont | $53.19 | Unavailable |
| Brazoria | $56.96 | Unavailable |
| Chicago | $58.62 | Unavailable |
| Chico | $61.80 | Unavailable |
| Colorado | $60.42 | Unavailable |
| Connecticut | $61.39 | Unavailable |
| Dallas | $57.26 | Unavailable |
| Dc + Md/Va Suburbs | $66.39 | Unavailable |
| Delaware | $56.87 | Unavailable |
| Detroit | $56.27 | Unavailable |
| East St. Louis | $54.39 | Unavailable |
| El Centro | $61.80 | Unavailable |
| Fort Lauderdale | $58.60 | Unavailable |
| Fort Worth | $56.80 | Unavailable |
| Fresno | $61.80 | Unavailable |
| Galveston | $57.09 | Unavailable |
| Hanford-Corcoran | $61.80 | Unavailable |
| Hawaii, Guam | $63.57 | Unavailable |
| Houston | $57.45 | Unavailable |
| Idaho | $53.36 | Unavailable |
| Indiana | $53.69 | Unavailable |
| Iowa | $53.07 | Unavailable |
| Kansas | $52.63 | Unavailable |
| Kentucky | $52.20 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $66.19 | Unavailable |
| Madera | $61.80 | Unavailable |
| Manhattan | $66.06 | Unavailable |
| Merced | $61.80 | Unavailable |
| Metropolitan Boston | $66.86 | Unavailable |
| Metropolitan Kansas City | $54.58 | Unavailable |
| Metropolitan Philadelphia | $59.68 | Unavailable |
| Metropolitan St. Louis | $55.21 | Unavailable |
| Miami | $60.39 | Unavailable |
| Minnesota | $58.34 | Unavailable |
| Mississippi | $50.78 | Unavailable |
| Modesto | $61.80 | Unavailable |
| Montana** | $57.45 | Unavailable |
| Napa | $72.62 | Unavailable |
| Nebraska | $53.43 | Unavailable |
| Nevada** | $57.38 | Unavailable |
| New Hampshire | $59.28 | Unavailable |
| New Mexico | $53.70 | Unavailable |
| New Orleans | $54.78 | Unavailable |
| North Carolina | $54.08 | Unavailable |
| North Dakota** | $57.05 | Unavailable |
| Northern Nj | $65.61 | Unavailable |
| Nyc Suburbs/Long Island | $67.50 | Unavailable |
| Ohio | $53.39 | Unavailable |
| Oklahoma | $52.30 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $65.99 | Unavailable |
| Portland | $62.63 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $62.48 | Unavailable |
| Puerto Rico | $57.95 | Unavailable |
| Queens | $66.90 | Unavailable |
| Redding | $61.80 | Unavailable |
| Rest Of California | $61.80 | Unavailable |
| Rest Of Florida | $55.73 | Unavailable |
| Rest Of Georgia | $52.53 | Unavailable |
| Rest Of Illinois | $53.76 | Unavailable |
| Rest Of Louisiana | $52.04 | Unavailable |
| Rest Of Maine | $53.46 | Unavailable |
| Rest Of Maryland | $58.06 | Unavailable |
| Rest Of Massachusetts | $59.95 | Unavailable |
| Rest Of Michigan | $53.47 | Unavailable |
| Rest Of Missouri | $50.98 | Unavailable |
| Rest Of New Jersey | $62.22 | Unavailable |
| Rest Of New York | $54.91 | Unavailable |
| Rest Of Oregon | $57.06 | Unavailable |
| Rest Of Pennsylvania | $53.58 | Unavailable |
| Rest Of Texas | $55.00 | Unavailable |
| Rest Of Washington | $59.90 | Unavailable |
| Rhode Island | $59.11 | Unavailable |
| Riverside-San Bernardino-Ontario | $62.02 | Unavailable |
| Sacramento-Roseville-Folsom | $65.12 | Unavailable |
| Salinas | $64.89 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $66.61 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $77.21 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $77.19 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $78.91 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $78.82 | Unavailable |
| San Luis Obispo-Paso Robles | $63.81 | Unavailable |
| Santa Cruz-Watsonville | $67.40 | Unavailable |
| Santa Maria-Santa Barbara | $65.18 | Unavailable |
| Santa Rosa-Petaluma | $68.10 | Unavailable |
| Seattle (King Cnty) | $68.44 | Unavailable |
| South Carolina | $53.80 | Unavailable |
| South Dakota** | $57.01 | Unavailable |
| Southern Maine | $56.78 | Unavailable |
| Stockton | $61.80 | Unavailable |
| Suburban Chicago | $59.30 | Unavailable |
| Tennessee | $52.88 | Unavailable |
| Utah | $54.58 | Unavailable |
| Vallejo | $72.59 | Unavailable |
| Vermont | $56.65 | Unavailable |
| Virgin Islands | $57.95 | Unavailable |
| Virginia | $56.46 | Unavailable |
| Visalia | $61.80 | Unavailable |
| West Virginia | $51.61 | Unavailable |
| Wisconsin | $55.02 | Unavailable |
| Wyoming** | $57.28 | Unavailable |
| Yuba City | $61.80 | Unavailable |
94452 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.
$50.53
$70.35
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $65.20 | 1 |
| AL | $51.31 | 1 |
| AR | $50.53 | 1 |
| AZ | $55.90 | 1 |
| CA | $61.80–$78.91 | 29 |
| CO | $60.42 | 1 |
| CT | $61.39 | 1 |
| DC | $66.39 | 1 |
| DE | $56.87 | 1 |
| FL | $55.73–$60.39 | 3 |
| GA | $52.53–$58.36 | 2 |
| GU | $63.57 | 1 |
| HI | $63.57 | 1 |
| IA | $53.07 | 1 |
| ID | $53.36 | 1 |
| IL | $53.76–$59.30 | 4 |
| IN | $53.69 | 1 |
| KS | $52.63 | 1 |
| KY | $52.20 | 1 |
| LA | $52.04–$54.78 | 2 |
| MA | $59.95–$66.86 | 2 |
| MD | $58.06–$66.39 | 3 |
| ME | $53.46–$56.78 | 2 |
| MI | $53.47–$56.27 | 2 |
| MN | $58.34 | 1 |
| MO | $50.98–$55.21 | 3 |
| MS | $50.78 | 1 |
| MT | $57.45 | 1 |
| NC | $54.08 | 1 |
| ND | $57.05 | 1 |
| NE | $53.43 | 1 |
| NH | $59.28 | 1 |
| NJ | $62.22–$65.61 | 2 |
| NM | $53.70 | 1 |
| NV | $57.38 | 1 |
| NY | $54.91–$67.50 | 5 |
| OH | $53.39 | 1 |
| OK | $52.30 | 1 |
| OR | $57.06–$62.63 | 2 |
| PA | $53.58–$59.68 | 2 |
| PR | $57.95 | 1 |
| RI | $59.11 | 1 |
| SC | $53.80 | 1 |
| SD | $57.01 | 1 |
| TN | $52.88 | 1 |
| TX | $53.19–$60.11 | 8 |
| UT | $54.58 | 1 |
| VA | $56.46–$66.39 | 2 |
| VI | $57.95 | 1 |
| VT | $56.65 | 1 |
| WA | $59.90–$68.44 | 2 |
| WI | $55.02 | 1 |
| WV | $51.61 | 1 |
| WY | $57.28 | 1 |
How the 94452 rate is calculated
Each of 94452’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 · 94452
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.30Practice expense 1.40Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 94452
The CMS indicators that decide how 94452 is paid alongside other services.
CMS payment indicators · 94452
Altitude simulation test
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
94452 without 26 · national office
$57.45
Altitude simulation test
94452-26 · Professional component
$14.70
Pays only the interpretation and report.
94452 compared with similar codes
Compare codes
94452 vs 94453 vs 94450: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 94453Altitude simulation
- 94452 covers simulated-altitude assessment with interpretation and report; 94453 identifies the service involving supplemental oxygen titration during that assessment.
- 94450Hypoxia response test
- Choose 94450 for testing the patient's breathing response to hypoxia. Choose 94452 for assessing oxygenation under simulated high-altitude conditions with interpretation and report.
94452 billing questions
How does 94452 differ from 94450?
94452 assesses oxygenation during simulated altitude exposure. Code 94450 evaluates the breathing response to hypoxia, rather than the result of a simulated aircraft-cabin exposure.
When should 94453 be considered?
Consider 94453 when the simulated-altitude assessment includes supplemental oxygen titration. The testing record should show the oxygen adjustments and the patient's response.
Which modifier identifies interpretation only?
Use modifier 26 with 94452 when billing the professional interpretation and report without the equipment and staff portion. Modifier TC identifies the technical portion; an unmodified claim represents both.
Can the oxygen saturation readings during the test be billed as a separate spot oximetry service?
Readings taken to monitor the simulated-altitude exposure support the 94452 test. They should not be recast as an independent spot measurement solely because an oximeter was used.
What documentation supports 94452?
Document the reduced-oxygen exposure, monitored oxygenation, and the physician's or qualified health care professional's interpretation and report.
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
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