How much does Medicare pay for CPT 94375?

Medicare allowed an average of $33.04 per service and paid $24.99 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $99.77, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 94375?

Test to measure rate of airflow. It was billed 185,962 times to 142,424 Medicare beneficiaries by 1,732 providers in 2024.

Does 94375 pay differently in an office than a hospital?

Yes. The allowed amount averaged $37.01 in an office setting and $14.05 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 94375 most?

Pulmonary Disease, with 111,471 services from 783 clinicians. Next are Allergy/ Immunology, Critical Care (Intensivists), Internal Medicine.

CPT 94375

Test to measure rate of airflow

$33.04Medicare-allowed amount per service, averaged across 185,962 services

Providers submitted

$99.77

Asking price, not received

Medicare allowed

$33.04

The fee schedule figure

Medicare paid

$24.99

Balance is patient coinsurance

Providers submitted an average of $99.77 for this code and Medicare allowed $33.04 — 3.0× 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 $24.99 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $37.01
Hospital / facility: $14.05

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. 153,830 services were billed in an office setting and 32,132 in a facility.

Services: 185,962
Beneficiaries: 142,424
Providers billing it: 1,732
Total allowed: $6,144,184

What Medicare pays for CPT 94375

Across 185,962 services billed by 1,732 providers to 142,424 beneficiaries, Medicare allowed an average of $33.04 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 94375

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	111,471	86,105	$32.03	783
Allergy/ Immunology	34,578	23,389	$37.67	434
Critical Care (Intensivists)	11,945	9,848	$29.13	97
Internal Medicine	11,847	9,550	$32.18	126
Nurse Practitioner	6,567	5,632	$30.91	138
Family Practice	2,040	1,755	$38.32	48
Physician Assistant	1,764	1,432	$31.09	49
Cardiology	1,457	1,072	$33.09	21
Independent Diagnostic Testing Facility (IDTF)	992	940	$36.78	3
General Practice	865	714	$41.74	3
Sleep Medicine	456	356	$29.33	2
Pediatric Medicine	339	250	$38.41	7
Pain Management	331	115	$31.96	1
Hospitalist	223	218	$29.74	4
Clinical Cardiac Electrophysiology	203	198	$41.95	3

94375 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	19,597	$39.92	$27.36	93
Texas	14,641	$35.51	$27.56	149
New York	14,312	$31.46	$20.76	93
Illinois	12,324	$31.29	$23.50	99
North Carolina	12,034	$25.43	$20.37	91
Pennsylvania	10,000	$33.01	$24.32	105
New Jersey	9,615	$41.38	$28.56	59
Arizona	6,694	$36.85	$28.64	34
Colorado	6,276	$27.48	$20.16	68
Florida	5,817	$36.39	$27.49	60
Missouri	5,557	$31.61	$25.42	54
Alabama	5,340	$32.62	$28.43	30
Georgia	5,173	$31.49	$24.95	55
Maryland	5,078	$36.43	$25.48	51
Minnesota	4,750	$34.26	$25.90	56
South Carolina	4,574	$34.61	$28.27	19
Kentucky	4,549	$32.18	$26.42	69
Tennessee	3,900	$33.64	$28.26	56
Mississippi	3,742	$23.36	$20.16	37
Indiana	3,482	$30.12	$24.03	63
Massachusetts	3,446	$19.71	$14.11	36
Nevada	3,258	$36.76	$27.80	16
Connecticut	3,046	$19.94	$14.52	41
Ohio	2,839	$32.99	$26.10	62
Kansas	2,403	$32.91	$26.10	16
Puerto Rico	2,291	$37.76	$27.55	28
Virginia	1,662	$34.59	$25.91	32
District of Columbia	1,430	$41.08	$28.02	19
Washington	1,404	$32.14	$22.28	27
Michigan	914	$34.28	$25.61	17
Nebraska	818	$13.20	$10.02	11
Arkansas	706	$32.83	$28.01	12
Louisiana	556	$13.40	$10.20	11
Oregon	545	$34.11	$25.27	9
Oklahoma	478	$27.13	$22.53	11
Iowa	453	$24.13	$19.52	5
Utah	447	$36.18	$28.77	6
Maine	388	$32.84	$24.11	10
West Virginia	302	$31.56	$28.17	2
New Mexico	265	$35.44	$28.04	4
Hawaii	261	$41.68	$28.88	2
Vermont	200	$13.24	$10.38	1
New Hampshire	159	$18.23	$12.34	4
Wisconsin	104	$13.29	$10.98	4
Delaware	56	$35.43	$27.70	2
Guam	48	$14.28	$10.81	1
Wyoming	28	$13.63	$10.50	2

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.