How much does Medicare pay for CPT 94070?

Medicare allowed an average of $56.92 per service and paid $44.20 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $163.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 94070?

Test to measure lung airway sensitivity. It was billed 11,541 times to 10,561 Medicare beneficiaries by 222 providers in 2024.

Does 94070 pay differently in an office than a hospital?

Yes. The allowed amount averaged $65.17 in an office setting and $26.42 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 94070 most?

Pulmonary Disease, with 4,531 services from 161 clinicians. Next are Internal Medicine, General Practice, Allergy/ Immunology.

CPT 94070

Test to measure lung airway sensitivity

$56.92Medicare-allowed amount per service, averaged across 11,541 services

Providers submitted

$163.44

Asking price, not received

Medicare allowed

$56.92

The fee schedule figure

Medicare paid

$44.20

Balance is patient coinsurance

Providers submitted an average of $163.44 for this code and Medicare allowed $56.92 — 2.9× 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 $44.20 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $65.17
Hospital / facility: $26.42

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. 9,084 services were billed in an office setting and 2,457 in a facility.

Services: 11,541
Beneficiaries: 10,561
Providers billing it: 222
Total allowed: $656,914

What Medicare pays for CPT 94070

Across 11,541 services billed by 222 providers to 10,561 beneficiaries, Medicare allowed an average of $56.92 per service. 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 94070

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	4,531	4,247	$45.04	161
Internal Medicine	3,008	2,834	$67.67	24
General Practice	1,287	1,120	$66.79	2
Allergy/ Immunology	402	220	$61.93	8
Independent Diagnostic Testing Facility (IDTF)	398	376	$57.94	3
Obstetrics & Gynecology	386	374	$64.18	1
Anesthesiology	340	292	$70.01	1
Nurse Practitioner	324	319	$61.11	2
Critical Care (Intensivists)	298	294	$34.64	12
Cardiology	282	202	$72.37	1
Otolaryngology	122	122	$67.14	2
Family Practice	92	90	$67.16	3
Hospitalist	37	37	$29.11	1
Physician Assistant	34	34	$23.27	1

94070 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
California	4,874	$67.63	$47.95	17
New York	1,207	$68.95	$44.75	18
Florida	827	$57.57	$45.36	16
Texas	605	$53.04	$42.97	12
Minnesota	601	$61.47	$44.77	13
Illinois	556	$33.49	$25.31	25
Massachusetts	387	$28.35	$20.69	15
Virginia	273	$60.01	$47.38	6
New Jersey	272	$58.78	$41.28	8
Wisconsin	196	$26.31	$19.46	12
Missouri	178	$26.04	$20.75	8
Tennessee	155	$53.80	$45.32	5
Michigan	155	$26.12	$20.04	6
Ohio	105	$25.94	$20.19	6
Kentucky	101	$26.20	$20.66	1
North Carolina	100	$26.20	$19.66	5
New Hampshire	89	$35.64	$25.27	5
Georgia	83	$38.90	$31.79	5
Arkansas	81	$34.48	$29.10	4
Arizona	80	$60.71	$42.90	4
Maryland	79	$51.01	$37.20	4
Louisiana	78	$25.19	$20.69	3
Pennsylvania	69	$30.95	$24.44	5
Alabama	58	$42.79	$37.23	4
Kansas	56	$25.39	$18.21	1
Iowa	43	$25.59	$21.11	1
Idaho	42	$32.88	$20.52	2
Oklahoma	35	$59.21	$47.95	1
Washington	32	$26.74	$20.42	2
South Carolina	26	$26.87	$21.07	2
Delaware	25	$26.61	$19.37	2
Mississippi	24	$25.91	$19.40	1
North Dakota	23	$26.27	$20.20	1
Utah	15	$58.68	$49.05	1
South Dakota	11	$26.14	$21.11	1

Related codes

94010Test to measure expiratory airflow and volume$21.18
94060Test to measure expiratory airflow and volume changes before and after$27.89
94004Nursing facility ventilation assistance and management$47.32
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.