Billing code 94621: Exercise testMedicare rate & RVUs

Reports integrated exercise testing with oxygen uptake and carbon dioxide measurement to assess the cause of exertional breathlessness or limited exercise capacity.

CMS RVU26DEffective Oct 1, 2026109 payment localities16.5K Medicare services in 2024

Medicare pays $165.67 for 94621 nationally in the office. Local office rates run $147.77–$220.87.

Medicare rate · 94621

Exercise test

Swap in your local Medicare rate.

Work RVUs
1.38
Total RVUs
4.96
Global days
XXX

National rate · 2026

$165.67

Office setting, before claim adjustments.

See every locality for 94621 → · 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 94621 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 94621 covers

This test evaluates heart and lung responses during controlled exercise by measuring oxygen uptake and carbon dioxide production as workload increases. It is used when symptoms such as unexplained exertional dyspnea or poor exercise tolerance require assessment of cardiopulmonary function. Testing is commonly performed in a pulmonary or cardiac function laboratory, with trained staff conducting the exercise protocol and a qualified clinician interpreting the results.

Select 94621 when the service is a comprehensive cardiopulmonary exercise evaluation, rather than a simpler pulmonary stress test or a test aimed specifically at exercise-induced bronchospasm. Documentation should identify the clinical indication, exercise protocol, measurements obtained, patient response, and interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier when billing the global 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 94621 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

$147.77 to $220.87

$147.77$184.32$220.87
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

94621 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$149.79Unavailable
Alaska*$194.94Unavailable
Arizona$161.62Unavailable
Arkansas$147.77Unavailable
Atlanta$168.28Unavailable
Austin$172.18Unavailable
Bakersfield$176.56Unavailable
Baltimore/Surr. Cntys$175.63Unavailable
Beaumont$154.96Unavailable
Brazoria$164.33Unavailable

94621 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$147.77

$198.56

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
94621 office rate range by state
State / territoryOffice rate rangeLocalities
AK$194.941
AL$149.791
AR$147.771
AZ$161.621
CA$176.25–$220.8729
CO$173.021
CT$176.201
DC$189.251
DE$164.201
FL$162.05–$175.043
GA$153.66–$168.282
GU$180.371
HI$180.371
IA$153.951
ID$154.761
IL$157.22–$171.464
IN$155.611
KS$152.991
KY$152.471
LA$152.14–$159.202
MA$171.97–$189.842
MD$167.28–$189.253
ME$155.21–$163.512
MI$155.91–$163.652
MN$166.931
MO$149.50–$160.083
MS$148.681
MT$165.661
NC$156.771
ND$163.881
NE$154.821
NH$170.071
NJ$178.53–$187.432
NM$156.601
NV$165.281
NY$158.95–$193.235
OH$155.551
OK$152.531
OR$164.31–$178.582
PA$155.94–$171.862
PR$166.911
RI$170.071
SC$156.361
SD$163.671
TN$153.671
TX$154.96–$172.188
UT$158.371
VA$162.80–$189.252
VI$166.911
VT$163.021
WA$171.73–$193.882
WI$158.691
WV$151.691
WY$164.891

How the 94621 rate is calculated

Each of 94621’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 · 94621

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.38Practice expense 3.49Malpractice 0.09

4.9600 adjusted RVUs×$33.4009 conversion factor=$165.67

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

Payment rules and modifiers for 94621

The CMS indicators that decide how 94621 is paid alongside other services.

CMS payment indicators · 94621

Exercise test

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

94621 without 26 · national office

$165.67

Exercise test

94621-26 · Professional component

$67.80

Pays only the interpretation and report.

When to use modifier 26

94621 compared with similar codes

Compare codes

94621 vs 94618 vs 94617 vs 94619 vs 94681: national Medicare rates

Swap in your local Medicare rate.

  • 94621
    Exercise test · 1.38 wRVU
    $165.67
  • 94618
    Pulmonary stress test · 0.47 wRVU
    $37.07−$128.60
  • 94617
    Exercise bronchospasm test · 0.68 wRVU
    $93.19−$72.48
  • 94619
    Exercise challenge · 0.48 wRVU
    $66.80−$98.87
  • 94681
    Gas-exchange analysis · 0.2 wRVU
    $50.10−$115.57

How to choose

94618Pulmonary stress test
94621 is the comprehensive cardiopulmonary test with oxygen uptake and carbon dioxide measurement. 94618 describes pulmonary stress testing without that same comprehensive gas-analysis focus.
94617Exercise bronchospasm test
Choose 94617 when the exercise test is intended to evaluate bronchospasm and includes ECG recording; 94621 evaluates broader cardiopulmonary responses during exercise.
94619Exercise challenge
94619 targets exercise-induced bronchospasm without ECG recording. 94621 is the comprehensive cardiopulmonary exercise evaluation.
94681Gas-exchange analysis
94681 focuses on oxygen uptake, carbon dioxide output, and oxygen extraction measurements. 94621 describes a comprehensive exercise evaluation rather than gas-exchange measurement alone.

94621 billing questions

When should 94621 be chosen over 94618?

Use 94621 for an integrated cardiopulmonary exercise evaluation with oxygen uptake and carbon dioxide measurement. Code 94618 is for pulmonary stress testing without that comprehensive gas-analysis focus.

How does 94621 differ from exercise bronchospasm testing?

94621 evaluates cardiopulmonary responses to exercise. Codes 94617 and 94619 are directed at exercise-induced bronchospasm; 94617 includes ECG recording, while 94619 is without it.

Which modifier reports the interpretation?

Use modifier 26 for the professional component, which represents interpretation. Modifier TC identifies the technical component for equipment and staff; reporting without either modifier represents the global service.

What documentation supports reporting 94621?

Document the reason for testing, exercise protocol, oxygen uptake and carbon dioxide measurements, patient response, and the clinician's interpretation.

Can the technical and professional components be billed separately?

Yes. CMS identifies separately priced professional and technical components for this diagnostic test, reported with modifiers 26 and TC, respectively.

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 94621PPRRVU2026_Oct_nonQPP.csv, line 12,407 (RVU26D)

Open CMS sourceHow we calculate rates

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