CPT 93000 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Cardiovascular Procedures |
| Common Place of Service | • 11 - Office • 20 - Urgent Care Facility |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
National average reimbursement for CPT 93000 by major payers:
$20.73
$24.02
$23.08
$27.64
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 93000 | ||||||
United | 93000 | $20.42 | 1538305768 - SOFFER HEART INSTITUTE PA | 263867908 - (FL) SOFFER HEART INSTITUTE | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93000 | $20.00 | 1023214418 - AMER SYED | 872676277 - UNITED MEDICAL GROUP 1 LLP | NJ | Internal Medicine Physician (207R00000X) |
United | 93000 | $20.00 | 1497779680 - ISABEL GONZALEZ | 823186672 - SANITAS MEDICAL CENTER OF NEW JERSEY PC | NJ | Pediatrics Physician (208000000X) |
United | 93000 | $17.91 | 1568996627 - ASIF UDDIN | 811200310 - CAPITAL HEALTH MULTISPECIALTY GROUP | NJ | Internal Medicine Physician (207R00000X) |
United | 93000 | $9.03 | 1790707263 - RADHA SYED | 263847741 | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 93000 | $31.49 | 1174681688 - HIDALBERTO CURNOW | 271348772 - VIRTUA MEDICAL GROUP PA | NJ | Internal Medicine Physician (207R00000X) |
United | 93000 | $17.31 | 1730187543 - HELEN SHIM- CHANG | 822534200 | NY | Dermatology Physician (207N00000X) |
United | 93000 | $81.37 | 1720247026 - KATHLEEN ATLAS | 510616510 - (NY) MSKCC CLINICAL PRACTICE PLAN | NY | Internal Medicine Physician (207R00000X) |
United | 93000 | $28.81 | 1447358700 - MADHURI BEWTRA | 943283324 - LIFELINE MEDICAL ASSOCIATES, LLC | NJ | Obstetrics & Gynecology Physician (207V00000X) |
United | 93000 | $67.18 | 1518987007 - MARCEL HINDS | 562669185 - NUVANCE HEALTH MEDICAL PRACTICE PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 93000 | $22.68 | 1184672172 - WILLIAM DIGIACOMO | 203368389 - WILLIAM A. DIGIACOMO M.D., L.L.C. | NJ | Internal Medicine Physician (207R00000X) |
United | 93000 | $17.14 | 1104400860 - KERALLA HANNA | 582501863 - ESSEN MEDICAL ASSOCIATES, P.C. | NY | Internal Medicine Physician (207R00000X) |
United | 93000 | $18.40 | 1154557460 - SAKINA DINANI | 844987479 - SYNERGY MEDICAL CARE LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 93000 | $12.09 | 1013395995 - HEATHER JONES | 871580108 - (NY) ALI RASHAN MD PLLC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 93000 | $22.68 | 1740395433 - WINSTON UMALI | 263938951 - WINSTON C. UMALI MD PC | NJ | Pediatrics Physician (208000000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 93000 vs. Other Cardiovascular Procedures Codes
The CPT 93000 code is part of the Medicine Services and Procedures services used for Cardiovascular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 93000 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 93000-CPT | Low | Ecg,Routine,Min.12 Lds;Interp/Reprt |
| 93005-CPT | Low | Electrocardiogram, Routine Ecg With At Least 12 Leads; Tracing Only, Without Interpretation And Report |
| 93010-CPT | Low | Ecg;Interpretation & Report Only |
| 93015-CPT | Low | Cardiovascular Stress Test Using Maximal Or Submaximal Treadmill Or Bicycle Exercise Continuous Electrocardiographic Monitoring And/Or Pharmacological Stress; With Supervision With Interpretation And Report (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93000 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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