CPT 94060: Spirometry with Bronchodilator Response Testing
Medicare pays $30 and commercial payers pay $148 on average nationally for this procedure.
CPT code 94060 describes spirometry with bronchodilator responsiveness testing, which records a graphical spirogram of forced vital capacity (FVC) and flow measures before and after administration of a bronchodilator to assess airway reversibility; service type: diagnostic pulmonary function test (spirometry with bronchodilator response); typical site of service: outpatient clinic, pulmonary function lab, or office-based respiratory testing.
For related coverage guidance, see recent payer policy updates: Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure, Bronchial Valves, Pulmonary Arterial Hypertension Endothelin Receptor Antagonists.
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National Reimbursement Benchmarks
Nationally, Medicare's mean rate of $30.2 for CPT 94060 sits substantially below BUCA’s average commercial mean of $148.1, indicating a sizable gap between public baseline reimbursement and the pooled commercial average. Blue Cross Blue Shield's mean of $221.3 and UnitedHealth Group's mean of $57.7 further illustrate commercial variability, with some payers clustering well above Medicare and others closer to it.
Assessing dispersion using the interquartile range (P75 − P25) highlights differences in rate concentration: Blue Cross Blue Shield has the tightest spread at $54.1 (P75 $241.3 − P25 $187.2), while Aetna shows a narrower-to-moderate spread of $29.0. UnitedHealth Group and Cigna exhibit wider dispersion at $49.3 and $50.1 respectively, and BUCA’s interquartile range is $50.1, signaling notable variability among commercial contracts.