CPT 94640

Across 114,624 services billed by 3,360 providers to 85,823 beneficiaries, Medicare allowed an average of $7.68 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.

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.

• 94618Test for exercise-induced lung stress$28.91
• 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
• 94617Test for exercise-induced spasm of lung airways$73.45
• 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

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.

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