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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
Fairfax, VA $35.79 $7.15 – $61.98 7,879 9
Dublin, OH $27.49 $0.00 – $188.52 7,906 16
Williamsburg, VA $34.96 $2.66 – $43.97 7,930 10
Babylon, NY $11.91 $6.82 – $30.34 7,951 7
Greenwood, MS $95.27 $2.32 – $97.16 7,958 5
Duarte, CA $33.23 $1.30 – $112.49 7,987 10
Rochelle Park, NJ $41.41 $4.02 – $41.57 8,003 2
Kettering, OH $68.99 $3.79 – $310.02 8,019 34
Upland, CA $23.72 $0.17 – $39.67 8,028 6
Casa Grande, AZ $7.01 $0.00 – $35.80 8,047 6
Kenosha, WI $24.40 $5.46 – $25.19 8,078 6
Clifton, NJ $26.72 $12.31 – $37.38 8,098 16
Medford, OR $16.44 $0.00 – $238.24 8,105 27
Fond Du Lac, WI $19.91 $5.25 – $25.05 8,111 3
Buffalo Grove, IL $35.65 $35.65 – $35.65 8,189 1
Goodyear, AZ $2.43 $0.18 – $21.24 8,227 9
Augusta, GA $44.92 $0.00 – $122.38 8,231 14
Richlands, VA $41.78 $5.84 – $44.65 8,250 5
Suffern, NY $10.30 $2.96 – $10.99 8,260 3
Troy, OH $50.32 $2.72 – $307.33 8,274 7
Helena, MT $10.97 $0.00 – $60.99 8,280 8
Olean, NY $18.50 $1.37 – $30.34 8,326 5
Providence, RI $23.82 $0.00 – $177.51 8,326 26
Idaho Falls, ID $10.03 $5.71 – $25.77 8,328 10
Pleasant Prairie, WI $26.31 $9.17 – $26.43 8,364 2
Boynton Beach, FL $30.68 $0.00 – $38.99 8,407 10
Hershey, PA $52.83 $0.00 – $219.93 8,424 30
Niagara Falls, NY $21.49 $0.13 – $30.74 8,434 8
Marrero, LA $14.67 $0.00 – $35.94 8,443 12
Boardman, OH $28.61 $7.04 – $293.28 8,453 15
Rockford, IL $14.15 $0.00 – $41.15 8,465 15
Southaven, MS $65.51 $8.88 – $71.08 8,465 7
Chico, CA $26.17 $0.97 – $31.83 8,491 3
Tempe, AZ $22.02 $0.00 – $36.72 8,501 14
Valhalla, NY $24.81 $11.69 – $37.75 8,527 10
Mayfield, KY $17.46 $11.19 – $21.72 8,535 3
Waterford, MI $26.84 $8.46 – $28.19 8,556 7
Oxford, MS $66.18 $6.15 – $76.16 8,559 5
Modesto, CA $32.33 $2.43 – $112.40 8,565 27
Monroe, LA $25.20 $0.00 – $83.12 8,577 26
Shelbyville, IN $14.39 $12.72 – $38.15 8,589 2
Binghamton, NY $35.25 $5.96 – $39.23 8,589 5
Great Neck, NY $21.09 $0.14 – $32.30 8,598 10
Concord, NC $24.68 $8.81 – $175.42 8,602 14
Santa Ana, CA $14.51 $0.00 – $32.20 8,629 12
Owosso, MI $13.65 $5.75 – $22.39 8,702 5
Lorain, OH $63.79 $5.87 – $171.95 8,721 11
Bellingham, WA $17.04 $5.45 – $70.60 8,726 15
Lincoln, NE $28.27 $0.00 – $75.40 8,733 25
Portland, OR $10.84 $0.00 – $44.51 8,745 76

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.