No office rate
Use 94011 for the infant spirometry service focused on breathing-capacity and expiratory-flow measurements; 94013 identifies lung-volume measurement.
On this page
CMS RVU26D · Effective 2026-10-01
94013 Lung-volume test Medicare reimbursement rates in Tennessee
Reports spirometry-technique lung-volume measurement in a child through age 2 as part of an age-specific pulmonary function assessment. Compare 94013 office and facility rates across CMS payment localities in Tennessee.
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 94013 in Tennessee?
Tennessee 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
$16.02
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 function testing
About 94013: Infant lung-volume measurement
Reports spirometry-technique lung-volume measurement in a child through age 2 as part of an age-specific pulmonary function assessment.
This service measures lung volumes using a spirometry technique in children through age 2. It is generally performed in a specialized pediatric pulmonary function laboratory by trained pulmonary function staff, such as a respiratory therapist, with physician oversight. The results help characterize pulmonary function when standard testing requiring active cooperation is not suitable for the child’s age.
Select the code when the documented service measures lung volumes, rather than only expiratory airflow or bronchodilator response. The record should support the child’s age, the spirometry technique, and the lung-volume measurements obtained. The Medicare Physician Fee Schedule represents payment through work, practice-expense, and malpractice RVUs; the practice-expense RVU listed for this code is the same in office and facility settings.
Where the value comes from
- Work RVU0.40 · 80%
- Practice expense (office) RVU0.07 · 14%
- Malpractice RVU0.03 · 6%
36
Medicare services in 2024 · #5559 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.
94013 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
94012 is the infant spirometry service that includes bronchodilator responsiveness testing. 94013 identifies lung-volume measurement by spirometry technique.
$27.29
94010 is the general spirometry code. 94013 is specific to spirometry-technique lung-volume measurement in children through age 2.
$58.38
Choose 94013 for lung-volume measurement using a spirometry technique; 94726 is for lung-volume determination by plethysmography.
Compare 94013 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$16.02
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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 94013 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
12,369
- Code
- 94013
- Physician work
- 0.40
- Practice expense
- 0.07
- Malpractice
- 0.03
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.40 | × 1.000 | 0.4000 |
| Practice expense | 0.07 | × 0.909 | 0.0636 |
| Malpractice | 0.03 | × 0.537 | 0.0161 |
| Total RVUs | 0.4797 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$16.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.4 | 1 |
| Practice expense | 0.07 | 0.909 |
| Malpractice | 0.03 | 0.537 |
(0.4 × 1 + 0.07 × 0.909 + 0.03 × 0.537) × $33.4009 = $16.02
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.
94013 billing questions
Which children qualify by age?
The code is for children through age 2. For an older child, use the code that matches the pulmonary function service performed and the applicable age-specific coding.
How does this differ from 94011?
94013 identifies lung-volume measurement by spirometry technique. 94011 describes infant spirometry focused on breathing-capacity and expiratory-flow measurements.
Is this the infant code for bronchodilator testing?
No. 94012 is the infant spirometry code that includes bronchodilator responsiveness testing; 94013 identifies lung-volume measurement.
What documentation supports reporting 94013?
Document the child’s age, the spirometry technique used, and the lung-volume measurements obtained. The test report should make clear that lung volumes were measured, not merely airflow.
How does 94013 differ from plethysmography?
94013 identifies lung-volume measurement by spirometry technique. Code 94726 describes lung-volume determination by plethysmography.
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.
12,36694010,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
12,36894012,,Spirmtry w/brnchdil inf-2 yr,A,,2.78,0.56,NA,0.56,,0.17,3.51,3.51,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36994013,,Meas lung vol thru 2 yrs,A,,0.40,0.07,NA,0.07,,0.03,0.50,0.50,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,37094014,,Patient recorded spirometry,A,,0.51,1.25,,1.25,NA,0.03,1.79,1.79,4,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,37194015,,Patient recorded spirometry,A,,0.00,1.04,,1.04,NA,0.01,1.05,1.05,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,37294016,,Review patient spirometry,A,,0.51,0.21,,0.21,,0.02,0.74,0.74,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780