$62.22–$65.61
Choose 94450 for a controlled test of breathing response to hypoxia. Choose 94452 when the study simulates altitude to evaluate oxygenation.
On this page
CMS RVU26D · Effective 2026-10-01
94450 Hypoxia response test Medicare reimbursement rates in New Jersey
Reports testing of a patient's breathing response during controlled hypoxia, typically in a pulmonary function laboratory when ventilatory response is being evaluated. Compare 94450 office and facility rates across CMS payment localities in New Jersey.
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 94450 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$123.34–$130.35
2 of 2 localities have a supported rate.
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 testing
About 94450: Breathing response to hypoxia test
Reports testing of a patient's breathing response during controlled hypoxia, typically in a pulmonary function laboratory when ventilatory response is being evaluated.
This pulmonary function study evaluates how a patient's breathing responds when the inspired oxygen level is reduced under controlled testing conditions. It may be performed in a pulmonary function laboratory or outpatient facility, with pulmonary staff conducting the test and a physician or qualified health care professional interpreting the findings. The clinical question is the ventilatory response to hypoxia, rather than oxygen saturation during exertion or oxygen needs at simulated altitude.
Report 94450 when the documented service is a controlled assessment of breathing response to hypoxia. The record should support the test performed, the measurements obtained, and the interpretation. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff portion, and reporting without either modifier represents the global service. The professional and technical portions may be billed separately when furnished by different entities.
CMS billing rules for 94450
- 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 RVU0.39 · 11%
- Practice expense (office) RVU2.97 · 87%
- Malpractice RVU0.04 · 1%
771
Medicare services in 2024 · #3189 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.
94450 compared with similar codes
Office rates for New Jersey, from the same CMS release.
$82.12–$86.56
94453 adds supplemental oxygen titration during high altitude simulation testing; 94450 evaluates ventilatory response to hypoxia.
$39.67–$41.39
94618 evaluates physiologic response during pulmonary stress testing, such as a walk test. It does not represent controlled hypoxia testing.
Compare 94450 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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$130.35
Facility
Unavailable
Rest Of New Jersey →
Office / nonfacility
$123.34
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
94450 billing questions
How does 94450 differ from a high altitude simulation test?
94450 evaluates the breathing response to controlled hypoxia. High altitude simulation testing evaluates oxygenation under simulated altitude conditions, with or without supplemental oxygen titration.
Does 94450 include both testing and interpretation?
Reporting without a component modifier represents the global service. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff.
What documentation supports reporting 94450?
Document the controlled hypoxia test performed, the measurements used to assess breathing response, and the interpreting clinician's findings.
When should modifier 26 or TC be used?
Use modifier 26 for the interpretation and modifier TC for the equipment and staff portion when billing those components separately. Report the service without either modifier when billing the global service.
Can exercise testing be reported instead of 94450?
A pulmonary stress test such as 94618 addresses physiologic response to exercise, including oxygen saturation monitoring. It is not a substitute when the documented service is a controlled assessment of breathing response to hypoxia.
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.
12,38594375,,Respiratory flow volume loop,A,,0.30,0.94,,0.94,NA,0.02,1.26,1.26,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,38694375,26,Respiratory flow volume loop,A,,0.30,0.12,,0.12,,0.01,0.43,0.43,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,38794375,TC,Respiratory flow volume loop,A,,0.00,0.82,,0.82,NA,0.01,0.83,0.83,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,38894450,,Breathing response hypoxia,A,,0.39,2.97,,2.97,NA,0.04,3.40,3.40,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,38994450,26,Breathing response hypoxia,A,,0.39,0.27,,0.27,,0.02,0.68,0.68,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,39094450,TC,Breathing response hypoxia,A,,0.00,2.70,,2.70,NA,0.02,2.72,2.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,39194452,,Hast w/i&r phys/qhp,A,,0.30,1.40,,1.40,NA,0.02,1.72,1.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00