CPT 94453
Global XXX ActiveHast w/suppl oxygen titrj
CPT 94453 Billing & Documentation Guide
CPT code 94453 (Hast w/suppl oxygen titrj) is classified under Pulmonary with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.39, a non-facility practice expense RVU of 1.84, and a malpractice RVU of 0.04, a total non-facility RVU of 2.27 and facility RVU of 2.27. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $78.58, though rates vary from $66.51 to $103.8 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 94453, 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 94453 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 94453 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 94453
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.39 | 0.39 |
| Practice Expense RVU | 1.84 | 1.84 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.27 | 2.27 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 94453
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 | $86.94 | $86.94 | $81.32 - $103.8 | 29 |
| Florida | $77.29 | $77.29 | $73.79 - $80.38 | 3 |
| Georgia | $73.28 | $73.28 | $69.44 - $77.11 | 2 |
| Illinois | $75.01 | $75.01 | $71.23 - $78.6 | 4 |
| Michigan | $72.62 | $72.62 | $70.65 - $74.59 | 2 |
| North Carolina | $71.22 | $71.22 | $71.22 - $71.22 | 1 |
| New York | $84.02 | $84.02 | $72.35 - $89.41 | 5 |
| Ohio | $70.48 | $70.48 | $70.48 - $70.48 | 1 |
| Pennsylvania | $74.77 | $74.77 | $70.71 - $78.83 | 2 |
| Texas | $74.84 | $74.84 | $70.19 - $79.26 | 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 94453
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 94453 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 94450 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 94452 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 94760 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 94761 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 99201 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99201 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 99202 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 94453
What does CPT code 94453 mean? +
CPT code 94453 represents: Hast w/suppl oxygen titrj. It's in the Pulmonary category with a global period of XXX.
What is the Medicare reimbursement for CPT 94453? +
The 2026 Medicare national average non-facility payment for CPT 94453 is $78.58. Rates range from $66.51 to $103.8 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 94453? +
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 94453? +
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 July 17, 2026.
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