Billing code 94016: Spirometry reviewMedicare rate & RVUs in Alaska

Reports a clinician’s interpretation of patient-initiated spirometry recordings collected during a 30-day monitoring period, separate from the technical service.

CMS RVU26DEffective Oct 1, 20261 payment locality6.8K Medicare services in 2024

Medicare pays $33.39 for 94016 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$33.39Office (non-facility)
$33.39Hospital or facility

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

We’ll open 94016 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 94016 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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.

94016 in Alaska*

94016 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$33.39$33.39

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.

How the rate is built · 94016

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.51Practice expense 0.21Malpractice 0.02

0.7400 adjusted RVUs×$33.4009 conversion factor=$24.72

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

Payment rules and modifiers for 94016

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

CMS payment indicators · 94016

Spirometry review

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/technical2Professional component only.

94016 compared with similar codes

Compare codes

94016 vs 94014 vs 94015 vs 94010: national Medicare rates

Swap in your local Medicare rate.

  • 94016
    Spirometry review · 0.51 wRVU
    $24.72
  • 94014
    Remote spirometry · 0.51 wRVU
    $59.79+$35.07
  • 94015
    Remote spirometry · 0 wRVU
    $35.07+$10.35
  • 94010
    Spirometry · 0.17 wRVU
    $29.73+$5.01

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.

94016 billing questions

How does 94016 differ from 94014?

94016 represents professional review, interpretation, and reporting. Code 94014 represents the technical recording service.

Can 94016 be reported with 94014?

Yes, when the technical recording service and the professional interpretation are both furnished and documented for the monitoring period.

Does 94016 need modifier 26?

No modifier is needed to identify the professional component; 94016 is already a professional-component-only code.

Is 94016 reported for each home spirometry maneuver?

No. The code is for review and reporting over a 30-day period, rather than for each individual recording.

What documentation supports 94016?

Keep the monitoring period, evidence that the patient-initiated recordings were reviewed, the clinician’s interpretation, and the resulting 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
RVUs for 94016PPRRVU2026_Oct_nonQPP.csv, line 12,372 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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