$60.76
94690 is limited to oxygen uptake measured at rest by indirect calorimetry. 94680 is for expired-gas analysis that includes additional gas-exchange measurements.
On this page
CMS RVU26D · Effective 2026-10-01
94690 Metabolic testing Medicare reimbursement rates in Colorado
Measures oxygen uptake at rest by indirect calorimetry to estimate resting energy expenditure when a patient’s nutritional needs require metabolic assessment. Compare 94690 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 94690 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$55.48
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Pulmonary function testing
About 94690: Resting indirect calorimetry
Measures oxygen uptake at rest by indirect calorimetry to estimate resting energy expenditure when a patient’s nutritional needs require metabolic assessment.
This test measures oxygen uptake while the patient is resting, using indirect calorimetry to estimate resting energy expenditure. It is used when a clinical team needs an individualized measure to support nutritional management, such as for a patient with complex energy needs. Testing is typically performed in a pulmonary or metabolic testing setting by trained staff using gas-analysis equipment, with a clinician interpreting the results.
Report 94690 for the resting indirect-calorimetry service, not for exercise testing or a broader expired-gas analysis. Documentation should identify the clinical reason for measuring resting energy expenditure, confirm that the measurement was obtained at rest, and include the test findings and interpretation. CMS recognizes a global service when billed without a component modifier, or separate professional and technical portions: modifier 26 represents interpretation, while modifier TC represents the equipment and staff portion. Both modifiers are separately priced under the CMS facts for this code.
CMS billing rules for 94690
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.07 · 4%
- Practice expense (office) RVU1.48 · 94%
- Malpractice RVU0.02 · 1%
8.2K
Medicare services in 2024 · #1575 by national volume
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.
94690 compared with similar codes
Office rates for Colorado, from the same CMS release.
$52.68
94690 reports resting indirect calorimetry. 94681 is expired-gas analysis that includes calculation of the respiratory quotient.
$173.02
94690 measures oxygen uptake at rest. 94621 is used for cardiopulmonary exercise testing, which evaluates the patient during exertion.
Compare 94690 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$55.48
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 94690 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
12,427
- Code
- 94690
- Physician work
- 0.07
- Practice expense
- 1.48
- Malpractice
- 0.02
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.07 | × 1.012 | 0.0708 |
| Practice expense | 1.48 | × 1.064 | 1.5747 |
| Malpractice | 0.02 | × 0.781 | 0.0156 |
| Total RVUs | 1.6612 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$55.48
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.07 | 1.012 |
| Practice expense | 1.48 | 1.064 |
| Malpractice | 0.02 | 0.781 |
(0.07 × 1.012 + 1.48 × 1.064 + 0.02 × 0.781) × $33.4009 = $55.48
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
94690 billing questions
When should 94690 be chosen instead of 94680?
Use 94690 for oxygen uptake measured at rest by indirect calorimetry. Code 94680 describes expired-gas analysis with a broader set of measurements.
How does 94690 differ from 94681?
94690 is specifically for resting oxygen uptake by indirect calorimetry. Code 94681 includes expired-gas analysis with calculation of the respiratory quotient.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion. Billing without either modifier represents the global service.
What documentation supports reporting 94690?
Document the clinical reason for measuring resting energy expenditure, that the patient was tested at rest, the measured findings, and the interpretation.
Is this code for a pulmonary exercise test?
No. 94690 reports resting oxygen uptake by indirect calorimetry; exercise-based pulmonary or cardiopulmonary testing is reported with a different code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,42494681,,O2 uptk co2 outp % o2 xtrc,A,,0.20,1.27,,1.27,NA,0.03,1.50,1.50,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,42594681,26,O2 uptk co2 outp % o2 xtrc,A,,0.20,0.08,,0.08,,0.01,0.29,0.29,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,42694681,TC,O2 uptk co2 outp % o2 xtrc,A,,0.00,1.19,,1.19,NA,0.02,1.21,1.21,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,42794690,,O2 uptk rest indirect,A,,0.07,1.48,,1.48,NA,0.02,1.57,1.57,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,42894690,26,O2 uptk rest indirect,A,,0.07,0.03,,0.03,,0.01,0.11,0.11,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,42994690,TC,O2 uptk rest indirect,A,,0.00,1.45,,1.45,NA,0.01,1.46,1.46,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,43094726,,Plethysmography lung volumes,A,,0.25,1.63,,1.63,NA,0.03,1.91,1.91,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899