$42.96
94060 covers spirometry before and after bronchodilator administration to assess response. If only a baseline spirometry study is performed, report 94010.
On this page
CMS RVU26D · Effective 2026-10-01
94010 Spirometry Medicare reimbursement rates in Delaware
Standard spirometry records forced vital capacity, timed expiratory flow, and a tracing when no pre- and post-bronchodilator response study is performed. Compare 94010 office and facility rates across CMS payment localities in Delaware.
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 94010 in Delaware?
Delaware 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
$29.41
1 of 1 localities have a supported rate.
Payment area: Delaware
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 94010: Standard spirometry without bronchodilator response testing
Standard spirometry records forced vital capacity, timed expiratory flow, and a tracing when no pre- and post-bronchodilator response study is performed.
The patient inhales fully and then exhales as hard and as long as possible into a spirometer. The test records forced vital capacity, FEV1, the FEV1/FVC ratio, and expiratory flow rates, with a volume-time or flow-volume tracing. Maximal voluntary ventilation may also be measured as part of the service. Respiratory therapists, pulmonary function technologists, or trained office staff perform testing in pulmonary and primary care offices, hospital pulmonary function labs, and occupational health clinics. A pulmonologist or other qualified clinician interprets the results. Common uses include COPD and asthma evaluation, preoperative assessment, and monitoring of known restrictive lung disease.
Report one unit for a standard spirometry study; repeated efforts to obtain acceptable results are part of that study. If spirometry is repeated after an administered bronchodilator to assess response, report the response study instead. Documentation should include tracings, effort quality and reproducibility, measured and predicted values, and a signed interpretation. CMS prices the professional and technical components separately: modifier 26 identifies interpretation, while modifier TC identifies equipment and staff services. An entity furnishing both components reports the global service without a component modifier.
CMS billing rules for 94010
- 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 RVU0.17 · 19%
- Practice expense (office) RVU0.70 · 79%
- Malpractice RVU0.02 · 2%
819.1K
Medicare services in 2024 · #167 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.
94010 compared with similar codes
Office rates for Delaware, from the same CMS release.
$69.16
94070 covers bronchial provocation with serial spirometry, such as a methacholine challenge. A standard spirometry study without provocation is 94010.
No office rate
94011 describes infant spirometry for children through age 2. Code 94010 describes standard spirometry performed with the patient's own forced expiratory effort.
$24.65
94016 is review and interpretation of patient-initiated spirometry recorded over time. Code 94010 is a supervised standard spirometry study.
Compare 94010 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
Delaware →
Office / nonfacility
$29.41
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 94010 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
12,364
- Code
- 94010
- Physician work
- 0.17
- Practice expense
- 0.70
- Malpractice
- 0.02
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.17 | × 1.005 | 0.1709 |
| Practice expense | 0.70 | × 0.988 | 0.6916 |
| Malpractice | 0.02 | × 0.899 | 0.0180 |
| Total RVUs | 0.8804 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$29.41
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.17 | 1.005 |
| Practice expense | 0.7 | 0.988 |
| Malpractice | 0.02 | 0.899 |
(0.17 × 1.005 + 0.7 × 0.988 + 0.02 × 0.899) × $33.4009 = $29.41
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.
94010 billing questions
Can 94010 be billed with 94060 on the same date?
Do not report 94010 for the baseline measurements included in the same pre- and post-bronchodilator study. Report 94060 for that study.
When should modifier 26 or TC be appended?
Use modifier 26 for interpretation only, such as when a physician interprets a test performed in a hospital pulmonary function lab. Modifier TC identifies the equipment and staff portion when that component is billed separately.
Is maximal voluntary ventilation billed separately?
No. Maximal voluntary ventilation is included in 94010 when performed as part of the spirometry study.
Can DLCO be added to spirometry?
Yes. When diffusing capacity is measured with the spirometry study, report add-on code 94729 with 94010.
What documentation supports the interpretation component?
The written report should address test quality and acceptability, compare results with predicted values, and state a clinical impression. Raw printouts without a signed interpretation do not support modifier 26.
Which code is used for spirometry in a toddler?
Code 94011 describes infant spirometry for children through 2 years of age. Code 94010 describes standard spirometry using the patient's own forced expiratory effort.
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.
12,36194003,,Vent mgmt inpat subq day,A,,1.37,0.28,NA,0.28,,0.12,1.77,1.77,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36294004,,Vent mgmt nf per day,A,,1.00,0.24,NA,0.24,,0.07,1.31,1.31,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36394005,,Home vent mgmt supervision,B,+,1.50,1.22,,1.22,NA,0.08,2.80,2.80,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36494010,,Breathing capacity test,A,,0.17,0.70,,0.70,NA,0.02,0.89,0.89,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36594010,26,Breathing capacity test,A,,0.17,0.07,,0.07,,0.01,0.25,0.25,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36694010,TC,Breathing capacity test,A,,0.00,0.63,,0.63,NA,0.01,0.64,0.64,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,36794011,,Spirometry up to 2 yrs old,A,,1.71,0.35,NA,0.35,,0.09,2.15,2.15,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503