How much does Medicare pay for CPT 94617?

Medicare allowed an average of $73.45 per service and paid $56.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $140.41, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 94617?

Test for exercise-induced spasm of lung airways. It was billed 5,647 times to 3,680 Medicare beneficiaries by 32 providers in 2024.

Does 94617 pay differently in an office than a hospital?

Yes. The allowed amount averaged $75.49 in an office setting and $30.06 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 94617 most?

Independent Diagnostic Testing Facility (IDTF), with 2,673 services from 2 clinicians. Next are Pulmonary Disease, Internal Medicine, Family Practice.

CPT 94617

Test for exercise-induced spasm of lung airways

$73.45Medicare-allowed amount per service, averaged across 5,647 services

Providers submitted

$140.41

Asking price, not received

Medicare allowed

$73.45

The fee schedule figure

Medicare paid

$56.70

Balance is patient coinsurance

Providers submitted an average of $140.41 for this code and Medicare allowed $73.45 — 1.9× 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 $56.70 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $75.49
Hospital / facility: $30.06

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. 5,394 services were billed in an office setting and 253 in a facility.

Services: 5,647
Beneficiaries: 3,680
Providers billing it: 32
Total allowed: $414,772

What Medicare pays for CPT 94617

Across 5,647 services billed by 32 providers to 3,680 beneficiaries, Medicare allowed an average of $73.45 per service. That is 1.5 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 94617

Specialty	Services	Beneficiaries	Avg allowed	Providers
Independent Diagnostic Testing Facility (IDTF)	2,673	1,459	$60.14	2
Pulmonary Disease	1,095	960	$71.23	16
Internal Medicine	825	789	$95.82	6
Family Practice	629	207	$102.77	1
Physical Medicine and Rehabilitation	202	119	$94.51	1
Nurse Practitioner	195	120	$55.39	4
Critical Care (Intensivists)	17	15	$93.27	1
Cardiology	11	11	$77.41	1

94617 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
Florida	2,798	$60.23	$47.30	5
New York	989	$101.09	$68.82	3
California	542	$98.51	$66.95	3
North Carolina	330	$82.10	$68.29	1
Illinois	237	$90.00	$68.14	1
Alabama	169	$73.95	$62.14	2
Virginia	123	$63.14	$50.31	2
Mississippi	109	$28.33	$24.46	4
Massachusetts	87	$95.52	$66.13	1
Texas	86	$60.20	$45.67	4
Connecticut	85	$32.37	$23.13	3
Ohio	39	$28.99	$25.79	1
South Carolina	38	$86.94	$69.56	1
Arizona	15	$30.24	$24.26	1

Related codes

94618Test for exercise-induced lung stress$28.91
94640Inhalation treatment for airway obstruction or sputum production$7.68
94664Evaluation of use of breathing device$17.91
94626Professional services for outpatient pulmonary rehabilitation$90.73
94625Professional services for outpatient pulmonary rehabilitation$76.69
94660Therapy procedure$63.51
94621Test for exercise-induced heart and lung stress$106.22
94690Test to measure exhaled air for evaluation of lung function at rest$44.15
94644Inhalation treatment for acute airway obstruction$62.88
94619Exercise test for spasm of lung airways$50.44
94681Test to measure exhaled air and carbon dioxide for evaluation of lung$23.41
94667Initial therapy service to facilitate lung function$26.89

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.