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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
Stanford, CA $29.33 $0.00 – $94.66 34,726 33
Fayetteville, NC $16.69 $8.32 – $75.63 34,952 42
Honolulu, HI $20.19 $1.65 – $135.21 35,019 23
Riverside, CA $29.34 $0.00 – $48.63 35,078 34
Charleston, WV $25.91 $0.00 – $48.10 35,184 28
Ashland, KY $42.54 $0.72 – $166.00 35,501 20
Chesapeake, VA $25.99 $0.94 – $44.72 35,734 24
Syracuse, NY $23.37 $0.00 – $164.48 35,829 39
Buffalo, NY $16.03 $1.81 – $195.66 35,865 43
Fort Worth, TX $156.42 $0.00 – $451.67 36,534 109
Nashville, TN $19.53 $0.00 – $178.20 36,937 108
Bridgeport, CT $14.52 $3.34 – $19.55 37,062 9
San Jose, CA $8.23 $0.00 – $41.05 37,835 29
Mobile, AL $20.96 $0.00 – $41.16 38,995 47
Fort Wayne, IN $23.30 $0.36 – $68.32 39,945 84
New Brunswick, NJ $62.66 $4.82 – $80.00 40,219 19
Madera, CA $18.74 $0.00 – $28.39 40,411 22
Stockton, CA $25.64 $0.47 – $58.20 41,429 23
Lansing, MI $16.67 $1.11 – $26.11 41,598 16
San Bernardino, CA $10.27 $1.33 – $38.89 41,732 18
South Richmond Hill, NY $28.29 $0.31 – $37.49 42,485 5
Salinas, CA $31.54 $0.00 – $40.93 42,672 19
New Orleans, LA $24.84 $0.00 – $526.18 42,684 89
Baltimore, MD $17.38 $0.00 – $246.88 42,923 103
Terre Haute, IN $15.22 $1.20 – $66.60 43,105 17
Greenville, SC $19.41 $1.52 – $102.49 43,948 41
Tacoma, WA $8.70 $4.19 – $132.27 44,534 36
Birmingham, AL $13.22 $0.00 – $40.72 44,697 123
Palo Alto, CA $21.03 $0.00 – $83.78 46,202 27
Hackensack, NJ $112.23 $6.72 – $207.40 47,188 15
Columbia, SC $36.74 $0.00 – $479.57 47,658 59
Madison, WI $20.98 $1.98 – $176.32 48,264 37
Jersey City, NJ $28.03 $3.53 – $68.10 49,181 21
Paterson, NJ $32.85 $1.93 – $68.31 49,522 28
Winter Park, FL $14.20 $0.39 – $61.71 49,725 8
Camden, NJ $74.43 $1.71 – $230.74 49,837 16
Hattiesburg, MS $59.07 $4.46 – $149.21 50,079 33
Saginaw, MI $10.81 $2.32 – $26.99 50,371 20
Dearborn, MI $15.04 $1.74 – $29.25 50,880 31
Royal Oak, MI $21.88 $0.00 – $118.60 51,085 10
Little Rock, AR $25.37 $0.00 – $44.70 51,099 42
Baton Rouge, LA $27.60 $0.64 – $106.47 51,425 93
Newark, NJ $87.92 $1.98 – $172.99 52,039 29
Toledo, OH $67.76 $0.00 – $270.19 52,762 91
Charlotte, NC $19.29 $0.00 – $192.86 53,462 140
Glendale, AZ $12.34 $0.00 – $33.23 53,643 22
Aurora, CO $27.18 $0.00 – $401.74 54,377 93
Miami, FL $7.18 $0.00 – $124.01 54,775 82
Atlanta, GA $40.25 $0.00 – $150.54 54,800 47
Spokane, WA $12.78 $0.68 – $32.01 54,821 39

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.