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See a sample rate comparisonCPT 93005 Fee Schedule
Last Verified: October 2026
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.
Electrocardiogram Routine Ecg, Electrocardiogram Routine Ecg With At Least 12 Leadstracing Only Without Interpretation And Report Electrocardiogram Routine Ecg With At Least 12leads
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Common Place of Service | 11 - Office 41 - Ambulance - Land |
| Common Modifiers | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $7.01 national non-facility rate (2026) · View Medicare rates for 93005 |
| Medicaid Fee Schedule | $5.73 median of the 8 states in the free preview · View Medicaid rates for 93005 |
National average reimbursement for CPT 93005 by major payers:
$10.35
$12.85
$12.03
$12.96
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CPT 93005
5 of 25 sample ratesHigher to lower in this preview
Michael Riggenbach
The Nemours Foundation
$28.14Published rateMark Liberman
$14.86Published rateAntonio Pinna
Cleveland Clinic Florida A Nonprofit Corporation
$10.67Published rateBruce Roy
Precision Healthcare Specialists LLC
$9.01Published rateJorge Ravelo
Jorge E Ravelo Md PA
$5.40Published rate
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See a sample payer proposalCPT 93005 vs. Other Cardiovascular Procedures Codes
The CPT 93005 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 93005 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 | Electrocardiogram Routine Ecg, Electrocardiogram Routine Ecg With At Least 12 Leads With Interpretation And Report Electrocardiogram Routine Ecg With At Least 12 Leads With |
| 93005-CPT | Low | Electrocardiogram Routine Ecg, Electrocardiogram Routine Ecg With At Least 12 Leadstracing Only Without Interpretation And Report Electrocardiogram Routine Ecg With At Least 12leads |
| 93010-CPT | Low | Heart Test Review And Report, Physician Evaluation And Documentation Of Electrocardiogram (Ecg Or Ekg) Test Results. The Test Is Used To Evaluate Heart Rate Rhythm And Conduction. |
| 93015-CPT | Low | Cardiovascular Stress Test, Cardiovascular Stress Test Using Maximal Or Submaximal Treadmill Or Bicycle Exercise Continuous Electrocardiographic Monitoring And Or Pharmacological Stress With Supervision Interpretation And Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93005 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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Frequently Asked Questions
CPT (Current Procedural Terminology) codes are a standardized set of five-digit codes used by healthcare professionals to describe medical, surgical, and diagnostic services provided to patients. They are crucial for billing and reimbursement processes, ensuring consistent communication between providers, payers, and patients.
Finding the exact cost of a medical procedure can be complex due to varying factors like your insurance plan, location, and specific provider. A good first step is to contact your insurance company for an estimate. For more precise, location-specific pricing information based on CPT codes, you can use specialized tools like Payerprice.
To look up specific CPT code pricing for your location, you can utilize tools designed for this purpose. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get relevant pricing data. This can help you understand potential costs before a procedure.
CPT (Current Procedural Terminology) codes describe the medical services and procedures performed by healthcare providers (what was done). ICD-10 (International Classification of Diseases, 10th Revision) codes, on the other hand, describe the diagnosis or condition of the patient (why it was done). Both are essential for medical billing and records.
Medical costs vary significantly due to multiple factors, including geographic location, the healthcare provider or facility, insurance negotiated rates, the patient's insurance plan (deductibles, co-pays, co-insurance), complexity of the procedure, and market competition. It's often difficult to get a single, standard price for a given service.
To estimate your out-of-pocket costs, start by contacting your insurance provider to understand your specific plan benefits, deductible status, co-pays, and co-insurance. Then, use a tool like Payerprice to look up typical costs for the CPT codes relevant to your procedure in your location. Combine this information with your insurance details to get an estimate. Always confirm with your provider and insurer.