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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
Richland, WA $17.46 $8.96 – $19.71 18,845 8
Northridge, CA $23.23 $0.00 – $25.30 18,924 4
Pueblo, CO $18.83 $0.00 – $225.67 18,967 33
Paducah, KY $20.30 $5.25 – $32.02 19,127 18
Florence, SC $24.88 $3.41 – $30.26 19,279 18
Springfield, MO $33.53 $4.11 – $568.21 19,325 44
Mount Clemens, MI $17.09 $4.52 – $119.00 19,358 5
Portland, ME $13.75 $5.00 – $23.54 19,524 13
Augusta, ME $22.68 $4.63 – $23.12 19,559 5
Visalia, CA $14.17 $0.00 – $22.80 19,658 11
Corona, CA $42.94 $0.00 – $53.84 19,687 12
Lima, OH $48.21 $0.00 – $174.86 19,694 20
St Petersburg, FL $34.74 $0.00 – $154.00 19,713 24
Gallipolis, OH $25.09 $5.51 – $155.47 19,919 12
La Crosse, WI $21.68 $0.86 – $145.99 20,173 11
La Mesa, CA $51.05 $0.00 – $425.38 20,369 9
Laveen, AZ $0.30 $0.30 – $0.30 20,461 1
San Luis Obispo, CA $31.01 $0.00 – $40.64 20,841 10
Shreveport, LA $29.81 $0.00 – $140.55 20,954 61
Minneapolis, MN $37.47 $0.00 – $159.74 21,006 93
Gilbert, AZ $21.40 $0.00 – $34.93 21,015 19
Rego Park, NY $16.57 $7.24 – $64.69 21,071 8
South Boston, VA $15.91 $10.00 – $34.10 21,108 7
Vancouver, WA $14.57 $4.83 – $38.81 21,149 17
Oroville, CA $24.55 $0.00 – $40.18 21,256 4
Anchorage, AK $80.33 $1.91 – $104.56 21,266 23
Midland, MI $12.16 $5.50 – $32.73 21,360 9
Mayaguez, PR $55.20 $0.00 – $65.53 21,471 11
Kingman, AZ $48.57 $0.00 – $57.32 21,608 11
Forest Hills, NY $31.17 $7.78 – $49.44 21,651 18
Apple Valley, CA $22.05 $0.00 – $39.82 21,699 12
New Hyde Park, NY $18.69 $3.47 – $62.14 21,825 22
Gonzales, LA $18.12 $7.78 – $35.75 21,847 8
Alexandria, VA $46.63 $5.66 – $62.18 21,884 12
Morristown, NJ $108.87 $5.65 – $150.88 22,236 11
Peoria, AZ $26.28 $0.00 – $30.45 22,373 26
Lewiston, ME $16.81 $3.13 – $21.41 22,510 14
Anaheim, CA $25.99 $0.00 – $93.01 22,704 21
Glasgow, KY $44.37 $8.72 – $59.35 22,819 4
Kew Gardens, NY $32.79 $18.98 – $43.90 22,843 4
Huntsville, AL $44.05 $0.00 – $48.53 22,935 34
Scottsdale, AZ $17.96 $0.00 – $76.16 22,948 29
Danbury, CT $29.26 $3.23 – $35.81 23,052 22
Jamaica, NY $25.38 $0.71 – $154.10 23,422 16
Huntington Beach, CA $24.91 $0.08 – $177.91 23,526 8
Port Huron, MI $11.53 $2.00 – $25.68 23,607 9
Redding, CA $48.56 $0.00 – $96.62 23,614 11
Las Cruces, NM $49.58 $9.93 – $198.54 23,861 24
Stamford, CT $18.91 $0.00 – $22.86 24,290 14
Loma Linda, CA $18.85 $0.00 – $35.20 24,328 18

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.