CPT 94640
Nebulizer (breathing) treatment
A breathing treatment with an inhaled drug delivered by nebulizer, the standard ER treatment for an asthma or COPD flare. The drug is billed separately. Repeat treatments during the same visit are billed with a modifier.
Billed to Medicare
$16
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$8
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
2x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 469 services.
Of the 10 er procedures and injections codes on this site with CMS figures, this one has the narrowest gap between billed and accepted. The widest is Simple wound repair, up to 2.5 cm at 9.9x.
Where this line goes wrong
Count the treatments
The nursing record lists each treatment given. Three billed and two recorded is a common finding.
Continuous treatment is a different code
A nebulizer running continuously for an hour or more is 94644, not several 94640s.
Check it, then ask
- 1
Ask for the nursing or respiratory therapy record and count the treatments.
- 2
Check the drug lines match the number of treatments.
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Codes that travel with this one
People also ask
Why was the breathing treatment billed three times?
Because three treatments were recorded, or because it was billed wrongly. The record decides which. Ask for it.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.