How much does Medicare pay for CPT 94010?

Medicare allowed an average of $21.18 per service and paid $15.89 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $86.78, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 94010?

Test to measure expiratory airflow and volume. It was billed 767,392 times to 611,993 Medicare beneficiaries by 8,547 providers in 2024.

Does 94010 pay differently in an office than a hospital?

Yes. The allowed amount averaged $25.57 in an office setting and $7.89 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 94010 most?

Pulmonary Disease, with 445,629 services from 4,111 clinicians. Next are Allergy/ Immunology, Internal Medicine, Critical Care (Intensivists).

CPT 94010

Test to measure expiratory airflow and volume

$21.18Medicare-allowed amount per service, averaged across 767,392 services

Providers submitted

$86.78

Asking price, not received

Medicare allowed

$21.18

The fee schedule figure

Medicare paid

$15.89

Balance is patient coinsurance

Providers submitted an average of $86.78 for this code and Medicare allowed $21.18 — 4.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $15.89 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $25.57
Hospital / facility: $7.89

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 576,881 services were billed in an office setting and 190,511 in a facility.

Services: 767,392
Beneficiaries: 611,993
Providers billing it: 8,547
Total allowed: $16,253,363

What Medicare pays for CPT 94010

Across 767,392 services billed by 8,547 providers to 611,993 beneficiaries, Medicare allowed an average of $21.18 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 94010

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	445,629	372,992	$19.46	4,111
Allergy/ Immunology	96,405	64,092	$26.07	1,269
Internal Medicine	74,008	63,103	$24.11	1,073
Critical Care (Intensivists)	46,409	39,563	$18.18	530
Nurse Practitioner	35,389	29,045	$20.49	574
Family Practice	20,249	17,019	$27.87	413
Physical Medicine and Rehabilitation	17,182	893	$24.76	4
Physician Assistant	9,861	8,088	$20.19	226
Cardiology	4,087	3,586	$28.64	57
Sleep Medicine	3,646	3,035	$20.40	33
Otolaryngology	3,326	1,549	$18.89	58
General Practice	1,852	1,475	$28.18	26
Hospitalist	1,700	1,380	$22.46	16
Neurology	1,575	1,095	$19.56	44
Pediatric Medicine	1,393	1,002	$26.84	31

94010 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	78,864	$27.37	$17.88	790
Texas	67,062	$20.78	$16.65	627
California	58,779	$24.98	$16.58	580
Florida	45,636	$22.59	$17.35	466
Virginia	34,807	$20.90	$14.96	280
Pennsylvania	32,485	$19.49	$14.42	338
New Jersey	32,378	$26.74	$18.24	320
Maryland	27,493	$24.60	$17.45	247
Tennessee	27,304	$19.21	$15.83	290
Georgia	24,773	$23.18	$18.00	320
South Carolina	21,413	$19.66	$15.70	194
Michigan	21,345	$15.85	$11.71	350
North Carolina	21,095	$21.53	$17.29	270
Ohio	19,678	$14.05	$10.96	291
Mississippi	19,216	$19.08	$16.53	84
Massachusetts	18,163	$18.11	$12.56	233
Arizona	16,929	$23.61	$18.21	180
Illinois	16,026	$18.91	$14.02	254
Missouri	14,481	$18.10	$14.10	161
Alabama	13,277	$18.13	$15.22	153
Wisconsin	11,176	$14.46	$11.10	157
Iowa	10,691	$14.45	$11.46	83
Kentucky	10,038	$18.81	$15.31	181
Indiana	9,885	$17.27	$13.84	159
Minnesota	9,583	$22.34	$16.54	117
Arkansas	9,448	$16.72	$14.57	61
Oklahoma	9,426	$19.41	$16.01	93
Louisiana	8,906	$16.57	$13.66	117
Connecticut	8,718	$25.61	$17.59	113
Kansas	7,864	$15.87	$12.63	75
Washington	7,721	$19.00	$13.53	149
Colorado	7,015	$22.74	$16.26	111
Utah	4,211	$13.71	$10.56	61
Oregon	3,861	$19.38	$14.20	71
New Hampshire	3,612	$14.28	$10.33	51
Nevada	3,483	$24.75	$19.02	41
New Mexico	3,360	$17.91	$14.15	51
Montana	3,192	$15.59	$11.53	41
Idaho	2,569	$15.07	$11.74	52
Rhode Island	2,561	$23.43	$16.99	48
North Dakota	2,511	$8.06	$6.10	22
Delaware	2,446	$20.98	$15.21	29
West Virginia	2,361	$17.51	$14.46	49
Nebraska	1,827	$20.59	$16.25	48
Vermont	1,753	$10.37	$7.89	24
South Dakota	1,732	$11.18	$8.50	21
District of Columbia	1,694	$19.41	$12.73	23
Maine	1,657	$11.99	$8.85	25
Alaska	1,552	$21.50	$13.76	20
Hawaii	579	$16.43	$11.32	10
Puerto Rico	270	$26.50	$19.69	9
Guam	207	$8.15	$5.78	1
U.S. Virgin Islands	203	$25.16	$19.61	4
Wyoming	76	$21.97	$16.47	2

Related codes

94060Test to measure expiratory airflow and volume changes before and after$27.89
94004Nursing facility ventilation assistance and management$47.32
94070Test to measure lung airway sensitivity$56.92
94003Follow-up inpatient or observation ventilation assistance and manageme$63.87
94016Test to measure expiratory airflow and volume initiated by patient and$24.25

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.