where can I find average cost for medical test-specifically "PFT"
(pulmonary function test). Since I self-pay all medical I have a very
hard time getting price info out of hospitals, etc before the test is
done.
also where can I find the code for a test. I was told by clinic that
she couldn't tell me cost unless I had the code (even with referral
Rx).
thanks

Hello.

From Germology:
"Pulmonary (Lung) Function Test ...
Costs: $35 - $125 "
Source: germology.com
http://www.germology.com/diagnostics.htm

There are basically three PFT tests: 
Code 94010: spirometry without bronchodilator (median cost $76)
Code 94060: spirometry with bronchodilator (median cost $129)
Code 94664: peak flow with bronchodilator (median cost $41). 
   
From "Office Spirometry," November 2002:
                                    
                                   CPT     Median charge 2001 
Medicare
                                   Code    (50th percentile)   Payment
2002

Spirometry without bronchodilator  94010   $76                 $37
Spirometry with bronchodilator     94060   $129                $63
Peak flow with bronchodilator      94664   $41                 $20

Source: Office Spirometry, November 2002, page 7, hosted by
corecontent.com:
http://www.corecontent.com/SpirometryHO2002.pdf

Medicare classifies the basic PFT as "spirometry" (code 94010). 
According, a recent issue of the American Association for Respiratory
Care newsletter, Medicare will reimburse between $24.60 and $42.33 for
this test.

Medicare reimbursement
CPT 94010: spirometry
Reimbursement Range: $24.60 to $42.33
Region
Western / Los Angeles $42.33
Midwest / Detroit $40.20
Eastern /Philadelphia $40.24
Source: American Association for Respiratory Care, July/August 2002
bulletin
http://www.aarc.org/sections/diagnostics_section/diag_july-aug02.pdf

Additional source:
"The median charge for a spirometry test (without bronchodilator, but
including a physician interpretation) is about $40, with a range of
$20 to $60."
Source: Occupational Safety & Health Administration
http://www.osha-slc.gov/SLTC/metalworkingfluids/mwf_finalreport_ch4.html

search strategy: 
"pulmonary function test", pft, spirometry, code 94010, payment, cost

I hope this helps.

---

Request for Answer Clarification by rehoboth-ga on 01 Apr 2003 06:10 PST

Not the answer looked for.

this answer isn't really a "real world" answer since I am paying for
the test. So far I have been quoted $400 for basic test and  "just
under $1000" for the complex test. The test I have scheduled seems to
be between the two
at $588. Also the codes you quoted aren't the codes I found for the
test. (94620 basic and 94621 complex)

I am still interested in the larger question of where online I can
find "national average" costs for common medical tests, such as PFT
(others would include: chest X-ray, ammmogram,MRI, MRI, etc)

Can you try again?

---

Clarification of Answer by juggler-ga on 01 Apr 2003 10:43 PST

Hi rehoboth,

You said that you "specifically" needed a "Pulmonary FUNCTION Test."
That's just a spirometry, and that's the information that I provided.


Code 94620 is Pulmonary STRESS Testing. That is a not just a FUNCTION
test. 94620 is a much more complicated test than the FUNCTION test
that you indicated that you needed.

94620 involves a prolonged exercise test and and not one but TWO
function tests  (pre-spirometry and post-spirometry)
 
"94620    Pulmonary stress testing; simple (eg, prolonged exercise
test
              for bronchospasm with pre- and post-spirometry)
94621    Pulmonary stress testing; complex (including measurements
              of CO2 production, O2 uptake, and electrocardiogaphic
              recordings)
http://www.accuchecker.com/AccuLibrary/articles/pulmonarystresstesting.asp

Are you sure that you need a Pulmonary STRESS Test?

I am a Registered Respiratory Therapist and I perform the PFT's which
juggler-ga addresses.  I believe juggler-ga has done a great, accurate
job of answering the question.  He/she has the correct codes and cites
accurate price ranges.