CPT 94640: Airway Management and Sputum Induction
Medicare pays $9 and commercial payers pay $50 on average nationally for this procedure.
CPT code 94640 describes administration of oxygen or other airway-opening therapy to relieve an acute airway obstruction or to induce sputum for laboratory analysis; the service is an airway management or sputum induction procedure typically provided in emergency department, inpatient hospital, or acute care outpatient settings by qualified respiratory or acute care providers.
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
National means show a meaningful gap between public and commercial reimbursement for CPT 94640: Medicare averages $9 while BUCA (average commercial) averages $49.8, a difference of $40.8, indicating commercial contracts generally pay materially more than Medicare for this code. Blue Cross Blue Shield and UnitedHealth Group sit above other commercial payers in central tendency, while Aetna and Cigna are closer to lower commercial levels.
Dispersion measured by the interquartile range (P75–P25) highlights variability across payers. Blue Cross Blue Shield exhibits the widest IQR at $27.6, followed by BUCA at $24.8 and UnitedHealth Group at $15.5; Aetna ($29 to $12 = $17.0) and Cigna ($26.9 to $12.2 = $14.7) are comparatively tighter. Medicare’s IQR is $1, reflecting very narrow locality variation among its $9 median.