$27.77–$30.92
Use 94375 for the flow-volume loop service. Use 94010 when the documented service is spirometry, rather than treating a loop graphic alone as evidence of both services.
On this page
CMS RVU26D · Effective 2026-10-01
94375 Flow-volume loop Medicare reimbursement rates in Pennsylvania
Reports a respiratory test that plots airflow against lung volume during breathing maneuvers, helping assess airflow patterns in pulmonary evaluation. Compare 94375 office and facility rates across CMS payment localities in Pennsylvania.
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 94375 in Pennsylvania?
Pennsylvania 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
$39.47–$43.68
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 function testing
About 94375: Respiratory flow-volume loop test
Reports a respiratory test that plots airflow against lung volume during breathing maneuvers, helping assess airflow patterns in pulmonary evaluation.
During this pulmonary function test, the patient performs breathing maneuvers while equipment records airflow in relation to lung volume, producing a flow-volume tracing. Pulmonary function laboratories, hospital departments, and office-based respiratory practices commonly perform the test, with a respiratory therapist or other trained staff member coaching the maneuvers. Clinicians use the tracing to assess airflow patterns, including patterns that may suggest obstruction in the upper airway.
Report 94375 when the flow-volume loop test is performed and documented, rather than selecting it solely because a loop image appears in a broader pulmonary function report. The record should support the maneuver performed and the resulting tracing; the interpreting clinician’s findings support the professional service. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service.
CMS billing rules for 94375
- 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 RVU0.30 · 24%
- Practice expense (office) RVU0.94 · 75%
- Malpractice RVU0.02 · 2%
193.2K
Medicare services in 2024 · #395 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.
94375 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$40.45–$45.14
94060 represents spirometry with bronchodilator responsiveness testing. 94375 represents the flow-volume loop test, without that pre- and post-bronchodilator service definition.
$59.28–$66.37
94726 measures lung volumes using body plethysmography. 94375 records airflow in relation to lung volume during breathing maneuvers.
Compare 94375 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
Metropolitan Philadelphia →
Office / nonfacility
$43.68
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$39.47
Facility
Unavailable
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94375 billing questions
How does 94375 differ from 94010?
94375 represents a flow-volume loop tracing. 94010 represents spirometric testing; choose based on the service performed and documented, not simply the format of a report.
Can 94375 and 94010 be reported together?
A loop image alone does not establish that a separate spirometry service was performed. Documentation should identify each service being reported.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 94375?
Document the breathing maneuvers, the resulting flow-volume tracing, and the interpreting clinician’s findings when the professional component is reported.
Is 94375 reported per loop or per maneuver?
The CMS facts supplied for this code do not specify a unit rule. Document the test performed and the tracing obtained.
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.
12,38294200,,Lung function test (mbc/mvv),A,,0.05,0.42,,0.42,NA,0.02,0.49,0.49,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,38394200,26,Lung function test (mbc/mvv),A,,0.05,0.02,,0.02,,0.01,0.08,0.08,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,38494200,TC,Lung function test (mbc/mvv),A,,0.00,0.40,,0.40,NA,0.01,0.41,0.41,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,38594375,,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