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Reimbursement Codes
Conveniently listed for quick reference.
Code Description Rate
94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation (MVV). $ 35.00
94060 Spirometry, often referred to as pre/post spirometry, before and after bronchodilator (aerosol) for the purpose of bronchospasm evaluation. This procedure is the same as 94010 with the addition of nebulizer treatment delivering a bronchodilator and subsequent repeat of spirometry to measure efficacy of treatment. Post spirometry should be performed at least 10 minutes after nebulizer treatment is completed to give bronchodilator time to reach maximum effectiveness. $ 65.00
94375 Respiratory Flow Volume Loop, includes expiratory and inspiratory portion of loop. $ 35.00
A4614 Peak Flow Meters, Private and Medicaid: S8096, Physician Service: S8110 $ 21.95
A4614 Airzone Peak Flow Meter, Private and Medicaid: S8096, Physician Service: S8110 $ 21.95
A4614 Mini-Wright Standard or AFS Peak Flow Meters, Private and Medicaid: S8096,
Physician Service: S8110		 $ 21.95
A4627 Valve Holding Chambers, Private and Medicaid,
S8100 – Chamber no mask, S8101 – Chamber with mask		  
94620 Simple Pulmonary Stress Test, often referred to as the 6 minute walk. Measurements of blood pressure, respiratory rate, heart rate, oxygen saturation level (%), exertion scale measurement and the distance performed before and after walking the patient for 6 minutes. $ 120.00
94660 CPAP, Continuous Positive Airway Pressure, initiation and management. $ 52.00
94664 Aerosol inhalations for sputum mobilization, bronchodilation, or sputum induction for diagnostic purposes; initial demonstration and/or evaluation. $ 18.00
94664 In-Check DIAL $ 18.00
97535 In-Check DIAL $ 18.00
98960 In-Check DIAL $ 18.00
5994665 In-Check DIAL Modifier Code $ 18.00
94760 Oximetry, single determination, often referred to as a spot check is performed with patient in a sitting position. $ 9.00
94761 Oximetry, multiple determination, for the purpose of evaluating the patient while sitting, standing, and during exercise or exertion. $ 24.00
94762 Oximetry, continuous overnight monitoring, for the purpose of determining oxygen saturation levels and heart rate patterns during the hours of sleep. $ 40.00
94770 Carbon dioxide, expired gas determination by infrared analyzer $ 24.00
Reorder # Description Quantity NHRIC/NDC#
Peak Flow Meters
3130045 Airzone Peak Flow Meter (universal 60-720LPM) each 3 8462130045 0
3130045 Airzone Peak Flow Meter (universal 60-720LPM) 10/case 10 38462130045 7
3103104 Mini-Wright Peak Flow Meter (standard, ATS, 60-800) each 3 8462103104 0
3103104 Mini-Wright Peak Flow Meter (standard, ATS, 60-800) 10/case 10 38462103104 7
3104001 Mini-Wright Peak Flow Meter (low range, ATS, 30-400) each 3 8462104001 1
3104001 Mini-Wright Peak Flow Meter (low range, ATS, 30-400) 10/case 10 38462104001 8
Peak Flow Meter Accessories
3104039 Windmill Trainer for Mini-Wright (blue) each 3 8462104039 4
3104044 Windmill Trainer for Mini-Wright (blue/red) each 3 8462104044 8
3104044 Windmill Trainer for Mini-Wright (bluebags) 5/bag 3 8462122066 6
3122062 One-Way Valve EXP Mouthpieces 5 bags of 20 3 8462122062 8
3122064 One-Way Valve EXP Mouthpieces 200/box 3 8462122064 2
3122066 One-Way Valve EXP Mouthpieces 500/box 3 8462122066 6
3122200 Adult Disposable Paper Mouthpiece 100/bag 3 8462122200 4
3123200 Pediatric Disposable Paper Mouthpiece 100/bag 3 8462123200 3
3103014 Mini-Wright Standard replacement pointer 100/bag 3 8462103014 2
3104028 Airzone &Mini-Wright AFS replacement pointer 100/bag 3 8462104028 8
Inspiratory Training Instruments
3109912 In-Check Dial w/info scale each 3 8462109912 5
3109750 In-Check Oral each 3 8462109750 3
3109751 In-Check Nasal w/mask each 3 8462109751 0
Inspiratory Training Accessories
3122061 One-Way Valve INSP Mouthpieces 5 bags of 20 3 8462122061 1
3122069 One-Way Valve INSP Mouthpieces 200/box 3 8462122069 7
3122065 One-Way Valve INSP Mouthpieces 500/box 3 8462122065 9
2005100 Pillow Mask - Adult each 3 8462005100 1
2004100 Pillow Mask - Pediatric each 3 8462004100 2
285100 Filtered Mouthpiece attachment (ICD & MW) each 3 8462285100 5
3122120 Pediatric/ Small Mouth disposable adaptor 100/box 3 8462122120 5
3122220 Pediatric/ Small Mouth disposable adaptor 20/bag 3 8462122220 2
Monitors
3102010 CO Monitor - carbon monoxide monitor each 3 8462102010 5
3141006 One-Flow Tester Screen monitoring spirometer each 3 8462141006 7
3141004 One-Flow Tester Memo monitoring spirometer w/ memory of 120 each 3 8462141006 7
3141005 One-Flow Tester Memo Kit monitoring spirometer w/software
and download options		 each 3 8462141005 0
3141007 One- Flow FVC Screen monitoring spirometer each 3 8462141007 4
3141002 One-Flow FEV6 monitoring spirometer each 3 8462141002 9
3141000 One-Flow FVC Memo monitoring spirometer w/ memory of 100 each 3 8462141000 5
3141001 One-Flow FVC Kit monitoring spirometer w/ software, pc downloads each 3 8462141001 2
Monitoring Accessories
3102011 CO Calibration Kit (17L can-regulator-tubing-adaptor) each 3 8462102011 2
3102008 CO Monitor replacement "T" pieces 10/box 3 8462102008 2
3102012 CO Chart Software & PC Cable each 3 8462102012 9
3141200 One-Flow "Soft" software each 3 8462141200 9
3141125 One-Flow PC Cable RS232 9pin each 3 8462141125 5
3141086 One-Flow Tester type mouthpiece each 3 8462141086 9
3102009 Disposable paper Mouthpiece for CO Monitor – UK 200/box 3 8462102009 9
3102013 Disposable paper Mouthpiece for CO Monitor – US 100/bag 3 8462102013 6
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NHRIC/NDC#
These numbers are the product numbers to use when filing for insurance reimbursements as well as a reference when looking for product reimbursement codes.
CPT Code Description Approximate Reimbursement Information

The following suggested use of CPT codes is only provided as a suggestion and is in no way an official recommendation or guideline. Charges vary widely across the nation.*

The following list is a range of CPT codes with reimbursement fees from published information from the Medicare allowables Unadjusted 2002. **

* Most commonly used CPT codes for spirometry. Additional Codes may be found in the current issue of “Current Procedural Terminology” (CPT) Manual, Published by the American Medical Association. All Spirometers may not perform all procedures identified or listed with CPT Codes.

** Actual Medicare and Medicaid allowables vary by geographic region. Contact your regional provider for specific coverage and allowables.