No office rate
Choose 94002 for the initial day of hospital inpatient or observation ventilator management; 94003 is for a subsequent service day.
On this page
CMS RVU26D · Effective 2026-10-01
94003 Ventilator management Medicare reimbursement rates in Hawaii
Reports a physician’s subsequent-day management of assisted or controlled ventilation for a patient receiving hospital inpatient or observation care. Compare 94003 office and facility rates across CMS payment localities in Hawaii.
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 94003 in Hawaii?
Hawaii 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
No supported rate
Facility setting
$58.71
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
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 medicine
About 94003: Subsequent inpatient ventilator management
Reports a physician’s subsequent-day management of assisted or controlled ventilation for a patient receiving hospital inpatient or observation care.
This service covers a physician’s subsequent-day management of a patient receiving assisted or controlled ventilation in a hospital inpatient or observation setting. The clinician evaluates the patient’s ventilatory status and directs ongoing ventilator care, including assessing the response to support and deciding whether management changes are needed. It is distinct from the initial-day service and from ventilator management in a nursing facility or at home. Hospital physicians caring for ventilated patients commonly report it; a respiratory therapist’s equipment adjustment alone does not describe the physician service.
Report 94003 for a later service day when the physician provides and documents ventilator management; use 94002 for the initial day. The record should support the patient’s ventilator-dependent status, relevant respiratory findings, clinical assessment, and management decisions for that date. Do not select the code solely because the patient remains connected to a ventilator or because settings are recorded without documented clinician management. The supplied CMS facts list no code-specific payment rules.
Where the value comes from
- Work RVU1.37 · 77%
- Practice expense (office) RVU0.28 · 16%
- Malpractice RVU0.12 · 7%
13.3K
Medicare services in 2024 · #1329 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.
94003 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
Choose 94004 when the ventilator-management service is furnished in a nursing facility, rather than in hospital inpatient or observation care.
94005
No office rateHome vent mgmt supervision
Choose 94005 for home ventilator-management supervision; 94003 describes subsequent-day management in a hospital inpatient or observation setting.
Compare 94003 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
Unavailable
Facility
$58.71
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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 94003 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
12,361
- Code
- 94003
- Physician work
- 1.37
- Practice expense
- 0.28
- Malpractice
- 0.12
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.000 | 1.3700 |
| Practice expense | 0.28 | × 1.137 | 0.3184 |
| Malpractice | 0.12 | × 0.579 | 0.0695 |
| Total RVUs | 1.7578 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$58.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1 |
| Practice expense | 0.28 | 1.137 |
| Malpractice | 0.12 | 0.579 |
(1.37 × 1 + 0.28 × 1.137 + 0.12 × 0.579) × $33.4009 = $58.71
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.
94003 billing questions
When should 94002 be used instead?
Use 94002 for the initial day of hospital inpatient or observation ventilator management. Use 94003 for a subsequent service day.
Is 94003 for a nursing facility patient?
No. 94003 is for hospital inpatient or observation care; 94004 is the related nursing-facility ventilator-management code.
Is a unit reported for each ventilator adjustment?
No. The code represents subsequent-day management, not an individual setting change. Document the physician’s management service for the date.
What documentation supports 94003?
Document the patient’s ventilatory status, relevant respiratory findings, clinical assessment, and decisions made about ongoing ventilator care that day.
Can it be reported just because the patient remains on a ventilator?
No. Continued ventilator use alone does not establish a management service; the record should show the physician’s assessment and management.
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.
12,35893990,TC,Doppler flow testing,A,,0.00,3.62,,3.62,NA,0.03,3.65,3.65,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,01,0,99,3.17,3.17,0.03
12,35993998,,Unlistd noninvas vasc dx std,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36094002,,Vent mgmt inpat init day,A,,1.99,0.40,NA,0.40,,0.18,2.57,2.57,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36194003,,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014