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CPT 94060: Spirometry with Bronchodilator Responsiveness Test
CPT code 94060 represents a spirometric evaluation performed before and after administration of a bronchodilator to assess bronchodilator responsiveness. This diagnostic pulmonary function test generates a spirogram and measures forced vital capacity and expiratory flow to document changes in lung function, aiding in diagnosis and management of obstructive airway diseases. Nationally, the code is relevant for outpatient pulmonary assessment, supporting clinical decision-making for conditions such as asthma, COPD, bronchodilator-responsive bronchospasm, and unexplained dyspnea.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose and typical settings for CPT code 94060, comparisons to related pulmonary function codes, and the common diagnostic contexts in which the test is used. The publication summarizes payer coverage considerations and operational implications for outpatient pulmonary function testing, and highlights where CPT code 94060 fits within the broader pulmonary diagnostic workflow.
This summary provides clinicians, billing staff, and policy analysts with the clinical context and coding relationships needed to identify appropriate use cases for CPT code 94060 and to align documentation and billing practices with payer expectations.
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Billing Code Overview
CPT code 94060 describes a spirometry test with bronchodilator responsiveness. The procedure records a graphical spirogram while measuring forced vital capacity (FVC) and expiratory flow before and after administration of a bronchodilator. The test evaluates changes in airflow and volumes to assess bronchial responsiveness.
Service Type: Diagnostic pulmonary function test (bronchodilator spirometry)
Typical Site of Service: Outpatient clinic, pulmonary function laboratory, or ambulatory care setting
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.