How much does Medicare pay for CPT 94660?

Medicare allowed an average of $63.51 per service and paid $47.53 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $163.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 94660?

Therapy procedure using a positive pressure ventilator. It was billed 26,862 times to 19,963 Medicare beneficiaries by 304 providers in 2024.

Does 94660 pay differently in an office than a hospital?

Yes. The allowed amount averaged $64.75 in an office setting and $33.65 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 94660 most?

Pulmonary Disease, with 10,436 services from 114 clinicians. Next are Sleep Medicine, Internal Medicine, Neurology.

CPT 94660

Therapy procedure using a positive pressure ventilator

$63.51Medicare-allowed amount per service, averaged across 26,862 services

Providers submitted

$163.89

Asking price, not received

Medicare allowed

$63.51

The fee schedule figure

Medicare paid

$47.53

Balance is patient coinsurance

Providers submitted an average of $163.89 for this code and Medicare allowed $63.51 — 2.6× 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 $47.53 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $64.75
Hospital / facility: $33.65

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. 25,797 services were billed in an office setting and 1,065 in a facility.

Services: 26,862
Beneficiaries: 19,963
Providers billing it: 304
Total allowed: $1,706,006

What Medicare pays for CPT 94660

Across 26,862 services billed by 304 providers to 19,963 beneficiaries, Medicare allowed an average of $63.51 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 94660

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	10,436	7,705	$63.35	114
Sleep Medicine	4,300	3,367	$69.36	37
Internal Medicine	3,276	2,214	$63.96	35
Neurology	2,074	1,680	$63.94	20
Nurse Practitioner	1,838	1,566	$53.18	33
Critical Care (Intensivists)	1,362	957	$64.97	13
Cardiology	1,296	825	$62.59	12
Family Practice	884	647	$63.06	7
Otolaryngology	719	592	$58.30	19
Diagnostic Radiology	341	106	$61.26	1
Physician Assistant	312	280	$55.57	11
Preventive Medicine	12	12	$56.34	1
Psychiatry	12	12	$60.31	1

94660 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	5,153	$75.35	$48.21	45
Florida	4,540	$62.11	$47.71	25
Texas	3,488	$61.07	$46.62	36
South Carolina	1,397	$61.97	$45.86	11
Arizona	1,187	$60.47	$44.54	18
Missouri	954	$60.07	$48.74	6
New Jersey	909	$69.56	$48.29	10
Georgia	874	$62.81	$46.07	17
Wisconsin	814	$35.39	$29.33	4
Connecticut	682	$68.17	$46.64	8
Illinois	664	$59.88	$42.61	20
North Carolina	602	$57.57	$44.30	7
Washington	594	$68.84	$48.05	4
Utah	551	$60.72	$45.26	1
New York	529	$68.87	$44.43	12
Colorado	415	$62.27	$43.49	11
Puerto Rico	407	$63.24	$45.97	2
Alabama	310	$53.99	$43.02	6
Indiana	308	$52.39	$41.51	2
Oklahoma	283	$49.42	$40.86	1
New Mexico	282	$60.89	$48.81	4
Ohio	278	$60.42	$45.43	9
Virginia	269	$61.69	$48.46	4
Kentucky	264	$57.73	$44.60	7
Michigan	170	$59.75	$48.82	8
Oregon	128	$56.42	$41.90	5
Pennsylvania	123	$50.31	$38.37	4
Nevada	108	$61.70	$48.51	1
U.S. Virgin Islands	103	$58.28	$47.75	3
Tennessee	99	$46.00	$35.77	1
Maryland	88	$69.11	$40.05	3
Louisiana	55	$56.23	$45.81	1
Delaware	51	$63.88	$50.55	1
Hawaii	46	$72.11	$49.49	1
Massachusetts	44	$69.64	$48.27	1
Mississippi	44	$43.18	$36.61	2
Minnesota	19	$63.08	$50.63	1
Arkansas	19	$54.60	$50.49	1
Iowa	11	$55.33	$46.32	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
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

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.