94621 Cardiopulm exercise testing
What 94621 is
CMS fee schedule short descriptor: Cardiopulm exercise testing.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 94621 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.38 | 3.49 | 0.09 | 4.96 | $165.67 |
| Facility (hospital, ASC) | 1.38 | 3.49 | 0.09 | 4.96 | $165.67 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 94621 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 94621? These codes are bundled into it
94621 is a Column 1 code in 67 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
00520 | Anes closed chest px nos | 0 - no modifier bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
93000 | Electrocardiogram complete | 1 - modifier may bypass | Check pair |
93005 | Electrocardiogram tracing | 1 - modifier may bypass | Check pair |
93010 | Electrocardiogram report | 1 - modifier may bypass | Check pair |
93015 | Cv stress test supvj i&r | 0 - no modifier bypass | Check pair |
93016 | Cv stress test supvj only | 0 - no modifier bypass | Check pair |
93017 | Cv stress test tracing only | 0 - no modifier bypass | Check pair |
93018 | Cv stress test i&r only | 1 - modifier may bypass | Check pair |
93040 | Rhythm ecg with report | 1 - modifier may bypass | Check pair |
93041 | Rhythm ecg tracing | 1 - modifier may bypass | Check pair |
93042 | Rhythm ecg report | 1 - modifier may bypass | Check pair |
94010 | Breathing capacity test | 1 - modifier may bypass | Check pair |
94011 | Spirometry up to 2 yrs old | 1 - modifier may bypass | Check pair |
94012 | Spirmtry w/brnchdil inf-2 yr | 1 - modifier may bypass | Check pair |
94060 | Evaluation of wheezing | 1 - modifier may bypass | Check pair |
94200 | Lung function test (mbc/mvv) | 1 - modifier may bypass | Check pair |
94617 | Exercise tst brncspsm w/ecg | 0 - no modifier bypass | Check pair |
94618 | Pulmonary stress testing | 0 - no modifier bypass | Check pair |
94680 | O2 uptk rst&xers dir simple | 0 - no modifier bypass | Check pair |
94681 | O2 uptk co2 outp % o2 xtrc | 0 - no modifier bypass | Check pair |
94690 | O2 uptk rest indirect | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99202 | Office o/p new sf 15 min | 1 - modifier may bypass | Check pair |
99203 | Office o/p new low 30 min | 1 - modifier may bypass | Check pair |
99204 | Office o/p new mod 45 min | 1 - modifier may bypass | Check pair |
Showing 30 of 67 column 2 codes. Use the pair checker for any specific combination.
94621 is bundled into these codes
94621 appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 94621 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
93351 | Stress tte complete | 0 | Check pair |
94070 | Evaluation of wheezing | 1 | Check pair |
C8930 | 0 | Check pair | |
G0237 | Therapeutic procd strg endur | 0 | Check pair |
G0238 | Oth resp proc, indiv | 0 | Check pair |
G0239 | Oth resp proc, group | 0 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.