Billing code 94010: SpirometryMedicare rate & RVUs in Texas
Standard spirometry records forced vital capacity, timed expiratory flow, and a tracing when no pre- and post-bronchodilator response study is performed.
Medicare pays $27.58–$31.02 for 94010 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 94010 covers
The patient inhales fully and then exhales as hard and as long as possible into a spirometer. The test records forced vital capacity, FEV1, the FEV1/FVC ratio, and expiratory flow rates, with a volume-time or flow-volume tracing. Maximal voluntary ventilation may also be measured as part of the service. Respiratory therapists, pulmonary function technologists, or trained office staff perform testing in pulmonary and primary care offices, hospital pulmonary function labs, and occupational health clinics. A pulmonologist or other qualified clinician interprets the results. Common uses include COPD and asthma evaluation, preoperative assessment, and monitoring of known restrictive lung disease.
Report one unit for a standard spirometry study; repeated efforts to obtain acceptable results are part of that study. If spirometry is repeated after an administered bronchodilator to assess response, report the response study instead. Documentation should include tracings, effort quality and reproducibility, measured and predicted values, and a signed interpretation. CMS prices the professional and technical components separately: modifier 26 identifies interpretation, while modifier TC identifies equipment and staff services. An entity furnishing both components reports the global service without a component modifier.
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.
Where 94010 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$27.58 to $31.02
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $31.02 | Unavailable |
| Beaumont | $27.58 | Unavailable |
| Brazoria | $29.41 | Unavailable |
| Dallas | $29.59 | Unavailable |
| Fort Worth | $29.36 | Unavailable |
| Galveston | $29.49 | Unavailable |
| Houston | $29.86 | Unavailable |
| Rest Of Texas | $28.47 | Unavailable |
How the 94010 rate is calculated
Each of 94010’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 94010
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.17Practice expense 0.70Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 94010
The CMS indicators that decide how 94010 is paid alongside other services.
CMS payment indicators · 94010
Spirometry
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
94010 without 26 · national office
$29.73
Spirometry
94010-26 · Professional component
$8.35
Pays only the interpretation and report.
94010 compared with similar codes
Compare codes
94010 vs 94060 vs 94070 vs 94011 vs 94016: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 94060Bronchodilator spirometry
- 94060 covers spirometry before and after bronchodilator administration to assess response. If only a baseline spirometry study is performed, report 94010.
- 94070Wheezing evaluation
- 94070 covers bronchial provocation with serial spirometry, such as a methacholine challenge. A standard spirometry study without provocation is 94010.
- 94011Infant spirometry
- 94011 describes infant spirometry for children through age 2. Code 94010 describes standard spirometry performed with the patient's own forced expiratory effort.
- 94016Spirometry review
- 94016 is review and interpretation of patient-initiated spirometry recorded over time. Code 94010 is a supervised standard spirometry study.
94010 billing questions
Can 94010 be billed with 94060 on the same date?
Do not report 94010 for the baseline measurements included in the same pre- and post-bronchodilator study. Report 94060 for that study.
When should modifier 26 or TC be appended?
Use modifier 26 for interpretation only, such as when a physician interprets a test performed in a hospital pulmonary function lab. Modifier TC identifies the equipment and staff portion when that component is billed separately.
Is maximal voluntary ventilation billed separately?
No. Maximal voluntary ventilation is included in 94010 when performed as part of the spirometry study.
Can DLCO be added to spirometry?
Yes. When diffusing capacity is measured with the spirometry study, report add-on code 94729 with 94010.
What documentation supports the interpretation component?
The written report should address test quality and acceptability, compare results with predicted values, and state a clinical impression. Raw printouts without a signed interpretation do not support modifier 26.
Which code is used for spirometry in a toddler?
Code 94011 describes infant spirometry for children through 2 years of age. Code 94010 describes standard spirometry using the patient's own forced expiratory effort.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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