$38.12–$42.30
94621 is the comprehensive cardiopulmonary test with oxygen uptake and carbon dioxide measurement. 94618 describes pulmonary stress testing without that same comprehensive gas-analysis focus.
On this page
CMS RVU26D · Effective 2026-10-01
94621 Exercise test Medicare reimbursement rates in Washington
Reports integrated exercise testing with oxygen uptake and carbon dioxide measurement to assess the cause of exertional breathlessness or limited exercise capacity. Compare 94621 office and facility rates across CMS payment localities in Washington.
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 94621 in Washington?
Washington 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
$171.73–$193.88
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 testing
About 94621: Comprehensive cardiopulmonary exercise test
Reports integrated exercise testing with oxygen uptake and carbon dioxide measurement to assess the cause of exertional breathlessness or limited exercise capacity.
This test evaluates heart and lung responses during controlled exercise by measuring oxygen uptake and carbon dioxide production as workload increases. It is used when symptoms such as unexplained exertional dyspnea or poor exercise tolerance require assessment of cardiopulmonary function. Testing is commonly performed in a pulmonary or cardiac function laboratory, with trained staff conducting the exercise protocol and a qualified clinician interpreting the results.
Select 94621 when the service is a comprehensive cardiopulmonary exercise evaluation, rather than a simpler pulmonary stress test or a test aimed specifically at exercise-induced bronchospasm. Documentation should identify the clinical indication, exercise protocol, measurements obtained, patient response, and interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for equipment and staff, or no component modifier when billing the global service.
CMS billing rules for 94621
- 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 RVU1.38 · 28%
- Practice expense (office) RVU3.49 · 70%
- Malpractice RVU0.09 · 2%
16.5K
Medicare services in 2024 · #1219 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.
94621 compared with similar codes
Office rates for Washington, from the same CMS release.
$96.83–$109.77
Choose 94617 when the exercise test is intended to evaluate bronchospasm and includes ECG recording; 94621 evaluates broader cardiopulmonary responses during exercise.
$69.41–$78.72
94619 targets exercise-induced bronchospasm without ECG recording. 94621 is the comprehensive cardiopulmonary exercise evaluation.
$52.20–$59.88
94681 focuses on oxygen uptake, carbon dioxide output, and oxygen extraction measurements. 94621 describes a comprehensive exercise evaluation rather than gas-exchange measurement alone.
Compare 94621 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
Rest Of Washington →
Office / nonfacility
$171.73
Facility
Unavailable
Seattle (King Cnty) →
Office / nonfacility
$193.88
Facility
Unavailable
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94621 billing questions
When should 94621 be chosen over 94618?
Use 94621 for an integrated cardiopulmonary exercise evaluation with oxygen uptake and carbon dioxide measurement. Code 94618 is for pulmonary stress testing without that comprehensive gas-analysis focus.
How does 94621 differ from exercise bronchospasm testing?
94621 evaluates cardiopulmonary responses to exercise. Codes 94617 and 94619 are directed at exercise-induced bronchospasm; 94617 includes ECG recording, while 94619 is without it.
Which modifier reports the interpretation?
Use modifier 26 for the professional component, which represents interpretation. Modifier TC identifies the technical component for equipment and staff; reporting without either modifier represents the global service.
What documentation supports reporting 94621?
Document the reason for testing, exercise protocol, oxygen uptake and carbon dioxide measurements, patient response, and the clinician's interpretation.
Can the technical and professional components be billed separately?
Yes. CMS identifies separately priced professional and technical components for this diagnostic test, reported with modifiers 26 and TC, respectively.
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.
12,40494619,,Exercise tst brncspsm wo ecg,A,,0.48,1.49,,1.49,NA,0.03,2.00,2.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,40594619,26,Exercise tst brncspsm wo ecg,A,,0.48,0.15,,0.15,,0.01,0.64,0.64,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,40694619,TC,Exercise tst brncspsm wo ecg,A,,0.00,1.34,,1.34,NA,0.02,1.36,1.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,40794621,,Cardiopulm exercise testing,A,,1.38,3.49,,3.49,NA,0.09,4.96,4.96,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,40894621,26,Cardiopulm exercise testing,A,,1.38,0.59,,0.59,,0.06,2.03,2.03,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,40994621,TC,Cardiopulm exercise testing,A,,0.00,2.90,,2.90,NA,0.03,2.93,2.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,41094625,,Phy/qhp op pulm rhb w/o mntr,A,,0.36,2.20,,0.08,,0.05,2.61,0.49,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00