CPT 94625 Pulmonary
Phy/qhp op pulm rhb w/o mntr Cost
Body System: Respiratory
Medicare Facility Rate
$16
CMS PFS CY2026
Medicare Non-Facility Rate
$87
Office/clinic setting
Hospital Outpatient
$60
OPPS rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.36
Work RVU
0.08
Facility PE RVU
0.05
Malpractice RVU
2.61
Total RVU
Frequently Asked Questions
How much does Phy/qhp op pulm rhb w/o mntr cost?
The Medicare facility rate is $16. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $60.
How much does Phy/qhp op pulm rhb w/o mntr cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $16.