How much does Medicare pay for CPT 95012?

Medicare allowed an average of $19.39 per service and paid $14.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $62.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95012?

Test to measure the level of nitric oxide gas. It was billed 93,780 times to 68,205 Medicare beneficiaries by 1,380 providers in 2024.

Which specialty bills 95012 most?

Pulmonary Disease, with 41,138 services from 463 clinicians. Next are Allergy/ Immunology, Nurse Practitioner, Critical Care (Intensivists).

CPT 95012

Test to measure the level of nitric oxide gas

$19.39Medicare-allowed amount per service, averaged across 93,780 services

Providers submitted

$62.47

Asking price, not received

Medicare allowed

$19.39

The fee schedule figure

Medicare paid

$14.75

Balance is patient coinsurance

Providers submitted an average of $62.47 for this code and Medicare allowed $19.39 — 3.2× 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 $14.75 (76%); the rest is the patient’s coinsurance and deductible.

Services: 93,780
Beneficiaries: 68,205
Providers billing it: 1,380
Total allowed: $1,818,394

What Medicare pays for CPT 95012

Across 93,780 services billed by 1,380 providers to 68,205 beneficiaries, Medicare allowed an average of $19.39 per service. That is 1.4 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 95012

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	41,138	29,537	$20.05	463
Allergy/ Immunology	37,484	25,947	$19.48	574
Nurse Practitioner	5,147	4,335	$15.40	132
Critical Care (Intensivists)	3,216	2,787	$19.72	51
Internal Medicine	2,664	2,330	$18.87	57
Physician Assistant	2,340	1,879	$16.30	68
Pediatric Medicine	651	450	$18.76	10
Family Practice	338	292	$17.24	6
Sleep Medicine	278	189	$18.27	1
Otolaryngology	231	208	$18.07	12
Rheumatology	199	168	$17.21	1
Emergency Medicine	36	33	$21.78	1
Certified Registered Nurse Anesthetist (CRNA)	18	11	$21.87	1
Osteopathic Manipulative Medicine	15	15	$19.50	1
Urology	14	13	$21.93	1

95012 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	14,155	$22.33	$13.99	163
New York	12,435	$22.01	$14.34	94
Florida	7,004	$18.21	$14.03	100
New Jersey	5,894	$21.42	$14.45	58
Texas	5,357	$17.97	$14.22	71
Georgia	4,645	$17.48	$13.73	83
Minnesota	3,561	$18.96	$13.76	77
Arizona	3,441	$17.87	$13.92	40
Connecticut	3,382	$20.41	$14.25	25
Illinois	3,074	$18.82	$14.23	46
Pennsylvania	2,927	$19.11	$13.97	39
Virginia	2,873	$19.78	$14.20	38
Kentucky	2,692	$15.84	$13.82	47
Ohio	2,142	$16.41	$13.56	59
North Carolina	2,005	$16.66	$13.75	56
South Carolina	1,821	$16.72	$14.11	33
Tennessee	1,737	$15.56	$13.48	32
Maryland	1,565	$20.04	$13.87	31
Indiana	1,563	$16.73	$13.84	33
Washington	1,267	$19.83	$13.43	39
Missouri	1,248	$16.34	$14.00	16
Colorado	1,088	$18.87	$13.68	25
Wisconsin	1,066	$17.23	$13.60	32
Michigan	976	$17.87	$13.85	15
Utah	633	$15.91	$13.33	14
New Mexico	557	$16.90	$13.99	9
Massachusetts	472	$19.22	$14.08	8
District of Columbia	455	$21.22	$13.75	5
Montana	442	$17.56	$13.64	9
Alabama	440	$15.92	$14.05	11
Oklahoma	430	$15.86	$13.29	11
Nebraska	382	$16.65	$13.59	11
Louisiana	372	$16.56	$14.09	8
Oregon	343	$18.07	$13.17	14
West Virginia	301	$15.02	$14.39	2
Vermont	179	$17.50	$14.71	1
Idaho	155	$16.46	$13.15	5
Iowa	131	$15.12	$11.76	3
Maine	128	$19.02	$13.70	4
Rhode Island	117	$18.68	$14.02	2
Kansas	110	$16.92	$14.36	3
North Dakota	71	$16.26	$14.14	2
Nevada	64	$18.10	$15.00	1
Alaska	64	$19.08	$13.84	4
Mississippi	16	$15.80	$14.80	1

Related codes

95004Test for allergy$3.65
95024Test for allergy$7.59
95044Test for allergy$5.08
95027Test for allergy$4.88
95018Test for allergy$17.77
95076Test for allergy$110.90
95070Test for allergy$34.15

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.