How much does Medicare pay for CPT 94667?

Medicare allowed an average of $26.89 per service and paid $20.43 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $46.09, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 94667?

Initial therapy service to facilitate lung function. It was billed 1,658 times to 1,046 Medicare beneficiaries by 26 providers in 2024.

Which specialty bills 94667 most?

Internal Medicine, with 518 services from 8 clinicians. Next are Family Practice, Nurse Practitioner, Allergy/ Immunology.

CPT 94667

Initial therapy service to facilitate lung function

$26.89Medicare-allowed amount per service, averaged across 1,658 services

Providers submitted

$46.09

Asking price, not received

Medicare allowed

$26.89

The fee schedule figure

Medicare paid

$20.43

Balance is patient coinsurance

Providers submitted an average of $46.09 for this code and Medicare allowed $26.89 — 1.7× 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 $20.43 (76%); the rest is the patient’s coinsurance and deductible.

Services: 1,658
Beneficiaries: 1,046
Providers billing it: 26
Total allowed: $44,584

What Medicare pays for CPT 94667

Across 1,658 services billed by 26 providers to 1,046 beneficiaries, Medicare allowed an average of $26.89 per service. That is 1.6 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 94667

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	518	373	$28.45	8
Family Practice	360	217	$27.79	7
Nurse Practitioner	286	171	$23.25	2
Allergy/ Immunology	199	23	$28.90	1
Pulmonary Disease	111	103	$23.23	5
Physical Medicine and Rehabilitation	84	73	$24.95	1
General Practice	78	64	$28.88	1
Hospitalist	22	22	$22.87	1

94667 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
New York	803	$27.38	$18.06	10
California	328	$28.89	$19.32	2
Florida	175	$23.90	$16.87	3
Arizona	78	$23.89	$18.82	4
Oklahoma	78	$28.88	$18.77	1
New Jersey	76	$28.29	$17.96	1
Indiana	35	$22.30	$16.52	1
Puerto Rico	33	$21.66	$19.58	1
South Carolina	22	$22.87	$17.93	1
North Carolina	16	$22.50	$18.39	1
Louisiana	14	$21.66	$18.34	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
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

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.