No office rate
94011 reports infant spirometry without bronchodilator testing. Choose 94012 when the service includes measurements before and after bronchodilator administration.
On this page
CMS RVU26D · Effective 2026-10-01
94012 Infant spirometry Medicare reimbursement rates in Vermont
Reports spirometry before and after bronchodilator administration for a patient age two years or younger when response testing is performed. Compare 94012 office and facility rates across CMS payment localities in Vermont.
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 94012 in Vermont?
Vermont 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
$114.25
1 of 1 localities have a supported rate.
Payment area: Vermont
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 94012: Infant spirometry with bronchodilator testing
Reports spirometry before and after bronchodilator administration for a patient age two years or younger when response testing is performed.
This service measures airflow in a patient age two years or younger before and after a bronchodilator is given. It is typically performed in a pediatric pulmonary function laboratory or specialty setting by trained pulmonary testing staff, with a physician interpreting the results. The measurements help assess airflow limitation and whether it changes after medication; the patient's young age makes this a distinct service from routine spirometry used for older patients.
Select this code when the documented service includes both the baseline spirometry and post-bronchodilator measurements. The record should support the patient's age, the medication administration, and the testing performed before and after it. Do not separately report the baseline-only infant spirometry code for the same pre- and post-medication testing service. CMS assigns physician-work, practice-expense, and malpractice relative values to this service.
Where the value comes from
- Work RVU2.78 · 79%
- Practice expense (office) RVU0.56 · 16%
- Malpractice RVU0.17 · 5%
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.
94012 compared with similar codes
Office rates for Vermont, from the same CMS release.
$42.73
94060 is the related pre- and post-bronchodilator spirometry code for patients outside the age group covered by 94012.
No office rate
94013 concerns lung-volume measurement in very young patients, not spirometry with bronchodilator response testing.
Compare 94012 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
Vermont →
Office / nonfacility
Unavailable
Facility
$114.25
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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 94012 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
12,368
- Code
- 94012
- Physician work
- 2.78
- Practice expense
- 0.56
- Malpractice
- 0.17
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.78 | × 1.000 | 2.7800 |
| Practice expense | 0.56 | × 0.990 | 0.5544 |
| Malpractice | 0.17 | × 0.506 | 0.0860 |
| Total RVUs | 3.4204 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$114.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.78 | 1 |
| Practice expense | 0.56 | 0.99 |
| Malpractice | 0.17 | 0.506 |
(2.78 × 1 + 0.56 × 0.99 + 0.17 × 0.506) × $33.4009 = $114.25
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.
94012 billing questions
When should 94012 be chosen instead of 94011?
Use 94012 when spirometry is performed before and after a bronchodilator for a patient age two years or younger. Use 94011 for the applicable age group when the service is spirometry without bronchodilator testing.
Can baseline spirometry be reported separately with 94012?
The baseline measurements are part of the pre- and post-bronchodilator service represented by 94012. Do not separately report 94011 for that same testing.
What documentation supports reporting 94012?
Document the patient's age, the spirometry measurements, the bronchodilator administered, and measurements obtained after administration. The record should show that both phases of testing were performed.
Is 94012 the right code for an older child receiving bronchodilator spirometry?
No. This code is limited to patients age two years or younger; 94060 is the related pre- and post-bronchodilator spirometry code commonly considered for older patients.
Does 94012 describe an infant lung-volume measurement?
No. It describes spirometry with bronchodilator testing. Code 94013 is the related infant service for lung-volume measurement.
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.
12,36594010,26,Breathing capacity test,A,,0.17,0.07,,0.07,,0.01,0.25,0.25,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,36694010,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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817