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Based on public Medicaid payment data.

Average Medicaid Pulmonary Function Test Payments

Typical Medicaid Pulmonary Function Test reimbursement across 4,055 cities

Avg. Medicaid Paid

$29.59

Price Range

$0.00 – $938.16

Total Claims

19.4M

Cities

4055

Typical Payment Range

Typical Medicaid Pulmonary Function Test payments fall between $7.79 and $27.18 per claim (median: $14.27). The top 10% of payments exceed $63.77.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Pulmonary function tests (PFTs) measure how well the lungs work. Used to diagnose and monitor lung diseases like asthma, COPD, and pulmonary fibrosis.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Cadillac, MI $8.42 $0.41 – $10.13 6,984 4
Wheeling, WV $32.10 $0.96 – $132.93 7,008 14
Rocky Mount, NC $10.36 $4.95 – $37.92 7,019 11
Morristown, TN $6.92 $0.00 – $18.20 7,045 15
Pittsfield, MA $61.81 $3.31 – $87.97 7,052 11
Kenner, LA $11.20 $6.46 – $16.21 7,077 11
Nashua, NH $16.80 $4.18 – $24.04 7,111 8
Briarwood, NY $16.21 $1.33 – $19.55 7,113 3
New Iberia, LA $16.01 $3.16 – $30.11 7,175 11
Cape May Court House, NJ $17.34 $6.00 – $24.98 7,195 5
West Islip, NY $26.82 $26.82 – $26.82 7,212 1
Homestead, FL $5.25 $0.00 – $32.59 7,226 14
Martinsburg, WV $19.26 $6.75 – $44.87 7,272 9
Elyria, OH $52.83 $4.43 – $227.84 7,287 6
Somers Point, NJ $9.12 $4.07 – $23.81 7,287 3
Marion, OH $52.04 $5.41 – $144.55 7,290 16
Anniston, AL $10.09 $4.49 – $22.30 7,298 21
Belleville, IL $6.07 $5.50 – $14.08 7,306 6
Conway, SC $5.42 $3.87 – $12.72 7,323 6
Jamestown, NC $15.88 $15.88 – $15.88 7,345 1
Jackson, TN $6.95 $0.00 – $193.88 7,361 30
Burlington, NC $12.32 $7.76 – $24.88 7,397 10
Mount Holly, NJ $9.54 $9.50 – $29.07 7,406 2
Sheboygan, WI $33.59 $8.43 – $35.77 7,439 4
Lafayette, IN $11.82 $9.70 – $27.82 7,440 18
Port Angeles, WA $18.15 $4.40 – $18.27 7,453 2
Jamestown, NY $15.95 $0.59 – $35.24 7,458 8
Midlothian, VA $31.91 $0.00 – $43.14 7,458 10
Brookfield, CT $16.00 $7.70 – $18.45 7,461 3
Stony Brook, NY $27.60 $8.38 – $166.36 7,463 11
Petoskey, MI $16.18 $6.35 – $29.09 7,468 3
Columbus, GA $22.59 $7.73 – $23.28 7,474 6
Melbourne, FL $11.22 $2.60 – $24.73 7,480 8
Orangeburg, SC $5.95 $2.87 – $13.07 7,526 5
Centralia, WA $7.22 $0.00 – $12.31 7,540 11
Newport Beach, CA $15.73 $0.00 – $48.19 7,558 9
Mcallen, TX $15.79 $2.07 – $42.97 7,573 21
Sylmar, CA $7.71 $3.66 – $88.66 7,633 3
Castro Valley, CA $19.91 $1.35 – $40.48 7,637 6
Chula Vista, CA $50.77 $0.00 – $57.90 7,647 8
Fairfield, CA $36.25 $4.70 – $39.38 7,649 7
Fort Collins, CO $25.42 $0.00 – $44.06 7,664 19
Florence, KY $49.76 $6.20 – $70.38 7,767 10
Oshkosh, WI $26.57 $6.14 – $34.53 7,771 7
Henderson, KY $37.26 $7.09 – $47.29 7,813 5
Corona, NY $27.25 $0.00 – $38.17 7,845 7
East Lansing, MI $11.75 $8.96 – $27.62 7,849 5
Brick, NJ $12.29 $7.30 – $30.21 7,854 8
Northfield, NJ $48.32 $47.92 – $49.72 7,862 2
Daphne, AL $15.98 $14.13 – $16.72 7,878 3

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
94640 Airway inhalation treatment $30.37 8,609,434 12,427
94010 Spirometry $25.10 3,948,184 7,404
94060 Spirometry pre & post bronch $45.36 2,638,065 6,502
94729 Diffusing capacity (DLCO) $21.36 2,183,703 5,880
94726 Plethysmography lung volumes $26.97 1,341,614 4,152
94375 Respiratory flow volume loop $31.08 795,469 1,665
94727 Gas dilution lung volume $21.85 595,656 1,579
94200 Max breathing capacity test $12.33 463,986 451
94150 Vital capacity test $9.49 274,717 389
94660 CPAP initiation/management $42.51 104,298 247
94728 Airway resistance oscillometry $26.43 61,324 92
94621 Pulmonary stress test complex $95.35 35,949 133
94070 Bronchospasm provocation eval $88.04 17,656 86
94620 Pulmonary stress test simple $7.99 35 1

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.