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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
Palm Springs, CA $20.23 $0.00 – $44.63 15,943 7
Merced, CA $29.66 $0.00 – $43.40 16,069 15
Kaufman, TX $24.41 $24.41 – $24.41 16,120 1
Middletown, CT $15.97 $3.50 – $36.55 16,299 7
Voorhees, NJ $17.78 $8.72 – $303.24 16,363 9
Saint Joseph, MI $11.84 $3.93 – $121.58 16,484 6
Great Falls, MT $11.96 $0.00 – $37.74 16,587 16
Beckley, WV $23.06 $0.00 – $55.13 16,706 13
Corinth, MS $38.83 $0.00 – $73.89 16,880 7
Yakima, WA $12.67 $2.92 – $25.30 16,938 7
Danville, VA $33.91 $4.42 – $89.90 16,952 11
North Bergen, NJ $24.01 $18.39 – $110.11 16,985 6
Rome, GA $34.37 $2.83 – $34.93 17,169 5
Eau Claire, WI $14.20 $3.61 – $29.53 17,210 16
Parkersburg, WV $25.36 $3.36 – $136.66 17,213 11
Torrance, CA $12.49 $0.00 – $35.15 17,260 17
West Columbia, SC $3.92 $2.13 – $21.96 17,385 10
Battle Creek, MI $13.49 $1.08 – $22.02 17,426 9
Billings, MT $19.72 $1.55 – $46.44 17,509 15
London, KY $28.48 $6.25 – $41.90 17,571 6
Jackson Heights, NY $31.34 $0.00 – $45.46 17,572 11
Trenton, NJ $24.81 $8.87 – $28.65 17,592 5
Ponce, PR $37.23 $0.00 – $59.55 17,656 11
Lakewood, CO $26.44 $1.96 – $77.50 17,729 18
Lowell, MA $71.68 $0.07 – $83.69 17,799 10
Warren, MI $5.74 $0.87 – $21.74 17,821 11
Chandler, AZ $15.87 $0.00 – $28.28 17,838 30
Lancaster, CA $92.08 $0.00 – $175.44 17,923 11
Fredericksburg, VA $43.13 $9.81 – $56.79 17,960 20
Princeton, WV $31.50 $3.01 – $35.17 17,962 7
Bayside, NY $28.06 $14.02 – $39.04 18,044 5
Wyoming, MI $16.95 $5.00 – $143.54 18,065 5
New London, CT $18.12 $0.00 – $20.17 18,066 5
Sioux Falls, SD $27.99 $6.31 – $199.31 18,085 11
Colorado Springs, CO $40.16 $0.00 – $508.22 18,114 54
Greensboro, NC $25.73 $7.12 – $163.30 18,209 48
Springfield, IL $24.20 $0.32 – $49.18 18,235 40
South Charleston, WV $34.29 $5.93 – $49.52 18,281 13
Woodbridge, VA $33.77 $5.11 – $47.51 18,307 14
Corbin, KY $26.75 $0.00 – $32.74 18,340 9
Elizabethtown, KY $39.21 $0.00 – $63.89 18,357 13
Cookeville, TN $11.36 $0.00 – $26.28 18,411 16
Virginia Beach, VA $42.97 $3.86 – $230.41 18,434 15
Norwich, CT $4.05 $0.00 – $16.73 18,464 15
Ferndale, MI $16.32 $16.32 – $16.32 18,521 1
Morehead, KY $39.81 $8.66 – $56.49 18,544 4
Jackson, MI $9.51 $0.00 – $49.29 18,545 9
Renton, WA $11.86 $4.19 – $14.83 18,555 9
Warren, OH $38.92 $4.85 – $345.11 18,561 17
Prescott, AZ $24.54 $6.56 – $49.14 18,664 12

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.