Billing code 94375: Flow-volume loopMedicare rate & RVUs in Virginia
Reports a respiratory test that plots airflow against lung volume during breathing maneuvers, helping assess airflow patterns in pulmonary evaluation.
Medicare pays $41.35–$48.29 for 94375 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 94375 covers
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.
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 94375 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $48.29 | Unavailable |
| Virginia | $41.35 | Unavailable |
How the 94375 rate is calculated
Each of 94375’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 · 94375
RVUs × geographic indexes × conversion factor
Work0.30
0.30 RVUs× 1.000 GPCI
Practice expense0.94
0.94 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.2600
Conversion factor
$33.4009
Medicare rate
$42.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 94375
The CMS indicators that decide how 94375 is paid alongside other services.
CMS payment indicators · 94375
Flow-volume loop
| 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
94375 without 26 · national office
$42.09
Flow-volume loop
94375-26 · Professional component
$14.36
Pays only the interpretation and report.
94375 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 94010Spirometry
- 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.
- 94060Bronchodilator spirometry
- 94060 represents spirometry with bronchodilator responsiveness testing. 94375 represents the flow-volume loop test, without that pre- and post-bronchodilator service definition.
- 94726Body plethysmography
- 94726 measures lung volumes using body plethysmography. 94375 records airflow in relation to lung volume during breathing maneuvers.
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 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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