CPT 94002
Global XXX ActiveVent mgmt inpat init day
CPT 94002 Billing & Documentation Guide
CPT code 94002 (Vent mgmt inpat init day) is classified under Pulmonary with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.99, a non-facility practice expense RVU of 0.4, and a malpractice RVU of 0.18, a total non-facility RVU of 2.57 and facility RVU of 2.57. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $86.92, though rates vary from $81.04 to $117.24 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 94002, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 94002 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 94002 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 94002
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.99 | 1.99 |
| Practice Expense RVU | 0.4 | 0.4 |
| Malpractice RVU | 0.18 | 0.18 |
| Total RVU | 2.57 | 2.57 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 94002
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $87.92 | $87.92 | $85.46 - $96.27 | 29 |
| Florida | $91.58 | $91.58 | $88.28 - $95.58 | 3 |
| Georgia | $86.51 | $86.51 | $85.55 - $87.46 | 2 |
| Illinois | $91.1 | $91.1 | $88.06 - $94.16 | 4 |
| Michigan | $87.48 | $87.48 | $85.45 - $89.5 | 2 |
| North Carolina | $82.77 | $82.77 | $82.77 - $82.77 | 1 |
| New York | $92.7 | $92.7 | $83.39 - $97.77 | 5 |
| Ohio | $84.73 | $84.73 | $84.73 - $84.73 | 1 |
| Pennsylvania | $86.57 | $86.57 | $84.41 - $88.74 | 2 |
| Texas | $85.57 | $85.57 | $84.21 - $88.54 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 94002
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 94002 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0543T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0544T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0548T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0567T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0568T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0569T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0570T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0571T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0572T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0573T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 94002
What does CPT code 94002 mean? +
CPT code 94002 represents: Vent mgmt inpat init day. It's in the Pulmonary category with a global period of XXX.
What is the Medicare reimbursement for CPT 94002? +
The 2026 Medicare national average non-facility payment for CPT 94002 is $86.92. Rates range from $81.04 to $117.24 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 94002? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 94002? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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