94727 measures lung volumes by inert gas dilution or nitrogen washout. 94726 uses a sealed body plethysmograph. Report one method for the session.
On this page
CMS RVU26D · Effective 2026-10-01
94726 Body plethysmography Medicare reimbursement rates in Guam
Report plethysmographic lung volumes to assess suspected restriction or air trapping; airway resistance measured during the body-box test is included. Compare 94726 office and facility rates across CMS payment localities in Guam.
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 94726 in Guam?
Guam 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
$70.83
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 94726: Lung volume measurement by body plethysmography
Report plethysmographic lung volumes to assess suspected restriction or air trapping; airway resistance measured during the body-box test is included.
During body plethysmography, the patient sits in a sealed body box and pants against a temporarily closed mouthpiece shutter. Pressure changes establish thoracic gas volume; the laboratory combines this measurement with spirometric values to derive functional residual capacity, residual volume, and total lung capacity. Airway resistance and conductance measured as part of plethysmography are included. Respiratory therapists or pulmonary function technologists perform the study in office or hospital pulmonary function laboratories, and a pulmonologist typically interprets it. Clinicians order it to investigate suspected restriction after a low vital capacity or to assess hyperinflation and air trapping in COPD or asthma.
Report one unit for a plethysmographic lung volume study; use 94727 instead when volumes are measured by gas dilution or washout. Document the method, quality of the maneuvers, measured volumes, and interpretation. CMS recognizes a professional component for physician interpretation (modifier 26) and a technical component for equipment and staff (modifier TC); an entity furnishing both bills the global service without a modifier. For a hospital outpatient test, the physician reports the interpretation with modifier 26, while the hospital bills its facility service. Diffusing capacity, when performed, is separately reported with add-on code 94729.
CMS billing rules for 94726
- 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 RVU0.25 · 13%
- Practice expense (office) RVU1.63 · 85%
- Malpractice RVU0.03 · 2%
640.2K
Medicare services in 2024 · #197 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.
94726 compared with similar codes
Office rates for Guam, from the same CMS release.
94728 measures airway resistance by oscillometry without a body box. Resistance measured as part of plethysmography is included in 94726.
94010 measures airflow and vital capacity by spirometry but cannot measure residual volume or total lung capacity. Those measurements require lung volume testing, such as 94726 or 94727.
Compare 94726 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
Hawaii, Guam →
Office / nonfacility
$70.83
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 94726 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
12,430
- Code
- 94726
- Physician work
- 0.25
- Practice expense
- 1.63
- Malpractice
- 0.03
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.25 | × 1.000 | 0.2500 |
| Practice expense | 1.63 | × 1.137 | 1.8533 |
| Malpractice | 0.03 | × 0.579 | 0.0174 |
| Total RVUs | 2.1207 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$70.83
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.25 | 1 |
| Practice expense | 1.63 | 1.137 |
| Malpractice | 0.03 | 0.579 |
(0.25 × 1 + 1.63 × 1.137 + 0.03 × 0.579) × $33.4009 = $70.83
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.
94726 billing questions
Can airway resistance be billed separately when it is measured in the body box?
No. Airway resistance measured as part of plethysmography is included in 94726 when performed. Code 94728 describes a different method, oscillometry.
Can 94726 and 94727 be reported together if both methods are used?
No. Both codes measure lung volumes, so report one method for the session: 94726 for the body box or 94727 for gas dilution or washout.
Is diffusing capacity separately billable with 94726?
Yes. Report add-on code 94729 with 94726 when diffusing capacity is also performed.
Which modifier does the pulmonologist use when the test is done in a hospital PFT lab?
The physician reports the interpretation with modifier 26. The hospital bills its facility service separately.
Is spirometry included in 94726?
No. Spirometry (94010) or pre- and post-bronchodilator spirometry (94060) may be reported separately when performed and documented.
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.
