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 — 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 |
|---|---|---|---|---|
| Charleston, WV | $25.91 | $0.00 – $48.10 | 35,184 | 28 |
| Riverside, CA | $29.34 | $0.00 – $48.63 | 35,078 | 34 |
| Honolulu, HI | $20.19 | $1.65 – $135.21 | 35,019 | 23 |
| Fayetteville, NC | $16.69 | $8.32 – $75.63 | 34,952 | 42 |
| Stanford, CA | $29.33 | $0.00 – $94.66 | 34,726 | 33 |
| Middle Village, NY | $29.50 | $9.43 – $50.11 | 34,626 | 5 |
| Long Beach, CA | $25.18 | $0.00 – $35.32 | 34,409 | 29 |
| Kansas City, MO | $53.72 | $0.00 – $825.19 | 34,292 | 74 |
| Pikeville, KY | $37.29 | $4.32 – $46.28 | 34,125 | 12 |
| Rochester, NY | $33.52 | $2.36 – $214.82 | 33,213 | 46 |
| Newport News, VA | $35.70 | $5.59 – $60.83 | 33,108 | 23 |
| Weslaco, TX | $21.46 | $3.54 – $28.34 | 32,947 | 20 |
| Salt Lake City, UT | $16.40 | $0.00 – $87.29 | 32,881 | 19 |
| Oklahoma City, OK | $23.21 | $4.62 – $96.87 | 32,357 | 81 |
| Orlando, FL | $15.86 | $0.00 – $215.24 | 32,331 | 83 |
| Bangor, ME | $14.65 | $0.02 – $26.22 | 32,147 | 14 |
| Roanoke, VA | $39.64 | $0.00 – $59.96 | 31,766 | 31 |
| Farmington Hills, MI | $17.20 | $0.00 – $165.25 | 31,575 | 10 |
| Green Bay, WI | $26.01 | $5.72 – $43.81 | 31,486 | 14 |
| Gulfport, MS | $56.14 | $0.94 – $98.98 | 31,302 | 10 |
| Hampton, VA | $32.90 | $4.99 – $41.40 | 31,250 | 14 |
| Muskegon, MI | $12.95 | $0.00 – $16.30 | 30,961 | 7 |
| Fort Myers, FL | $13.66 | $0.00 – $18.92 | 30,276 | 29 |
| Denver, CO | $24.33 | $0.37 – $229.00 | 30,112 | 72 |
| Tupelo, MS | $47.16 | $1.96 – $60.98 | 29,616 | 21 |
| Farmington, CT | $21.46 | $3.24 – $27.18 | 29,587 | 13 |
| Anderson, SC | $45.46 | $4.55 – $46.67 | 29,457 | 12 |
| Bowling Green, KY | $29.16 | $4.33 – $35.50 | 28,866 | 17 |
| El Paso, TX | $24.09 | $0.00 – $82.02 | 28,745 | 58 |
| Omaha, NE | $36.74 | $0.00 – $110.81 | 28,495 | 69 |
| Worcester, MA | $24.30 | $0.00 – $43.85 | 28,428 | 38 |
| Kalamazoo, MI | $14.05 | $1.10 – $32.80 | 28,297 | 13 |
| Iowa City, IA | $22.51 | $0.00 – $82.56 | 28,142 | 28 |
| Greenville, NC | $36.61 | $0.00 – $185.70 | 27,873 | 45 |
| Staten Island, NY | $22.78 | $0.00 – $48.41 | 27,845 | 27 |
| Glendale, CA | $10.07 | $0.00 – $107.14 | 27,246 | 25 |
| Durham, NC | $9.50 | $0.83 – $87.00 | 27,031 | 30 |
| Racine, WI | $24.19 | $5.11 – $26.27 | 26,650 | 3 |
| Yuma, AZ | $25.34 | $0.00 – $36.40 | 26,129 | 21 |
| Brockton, MA | $43.57 | $0.20 – $83.93 | 26,123 | 13 |
| Oakland, CA | $35.40 | $0.00 – $57.00 | 25,963 | 20 |
| Caguas, PR | $35.97 | $25.74 – $58.79 | 25,536 | 10 |
| Fall River, MA | $29.90 | $8.45 – $84.11 | 25,532 | 20 |
| Falls Church, VA | $44.87 | $3.52 – $51.40 | 25,495 | 21 |
| Brownsville, TX | $15.86 | $0.00 – $24.79 | 25,495 | 25 |
| Somerset, KY | $26.43 | $8.44 – $37.29 | 25,490 | 9 |
| San Francisco, CA | $14.27 | $0.00 – $78.94 | 25,465 | 68 |
| Chattanooga, TN | $18.71 | $3.31 – $120.31 | 25,463 | 68 |
| Lafayette, LA | $18.73 | $0.00 – $149.61 | 25,232 | 52 |
| Spartanburg, SC | $14.50 | $0.88 – $178.26 | 25,195 | 21 |
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.