CPT 93005 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 • 41 - Ambulance - Land |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 93005 |
National average reimbursement for CPT 93005 by major payers:
$10.35
$12.85
$12.03
$12.96
| 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 93005 | ||||||
United | 93005 | $10.48 | 1790770360 - AMARAVADI & AMARAVADI MD PA, AMAR & AMAR MD PA | 592201202 - (FL) AMARAVADI AMARAVADI MD PA | FL | Pulmonary Disease Physician (207RP1001X) |
United | 93005 | $5.40 | 1811977002 - JORGE RAVELO | 650773933 - (FL) JORGE E RAVELO MD PA | FL | Surgery Physician (208600000X) |
United | 93005 | $10.69 | 1215231055 - NICOLE FIGEL | 593730470 | FL | Surgery Physician (208600000X) |
United | 93005 | $9.01 | 1538187018 - BRUCE ROY | 921919591 - (FL) PRECISION HEALTHCARE SPECIALISTS LLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 93005 | $7.36 | 1619947652 - KAMAL ANJUM | 204052451 - (FL) PULMONARY CRITICAL CARE CONSULTANTS OF SOUTH FLORIDA PA | FL | Pulmonary Disease Physician (207RP1001X) |
United | 93005 | $18.15 | 1285783274 - MARK KENT | 621872083 | FL | Surgery Physician (208600000X) |
United | 93005 | $13.07 | 1679730295 - THOMAS CLEMENTS | 510426500 - MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC | FL | Urology Physician (208800000X) |
United | 93005 | $16.37 | 1649200023 - ALAN MILLER | 381359087 - (MI) BRONSON METHODIST HOSPITAL | FL | Urology Physician (208800000X) |
United | 93005 | $17.07 | 1962654806 - BJORN HERMAN | 592579938 - UNIVERSITY OF MIAMI | FL | Otolaryngology Physician (207Y00000X) |
United | 93005 | $28.14 | 1013126861 - MICHAEL RIGGENBACH | 590634433 - THE NEMOURS FOUNDATION | FL | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 93005 | $18.30 | 1427041623 - NAPLES SURGICAL ASSOCIATES PA | 320057272 - (FL) NAPLES SURGICAL ASSOCIATES PA | FL | Surgery Physician (208600000X) |
United | 93005 | $7.36 | 1386723567 - GUSTAVO PLASENCIA | 261869328 | FL | Colon & Rectal Surgery Physician (208C00000X) |
United | 93005 | $9.46 | 1154815546 - FOREFRONT DERMATOLOGY, S.C., ADVANCED DERMATOLOGY & SKIN CARE CENTRE | 391351587 - FOREFRONT DERMATOLOGY, S.C. | FL | Dermatology Physician (207N00000X) |
United | 93005 | $7.11 | 1578568515 - THOMAS MAHAN | 591447035 - (FL) SURGICAL ASSOCIATES OF CENTRAL FLORIDA PA | FL | Surgery Physician (208600000X) |
United | 93005 | $12.50 | 1033117783 - KIET DOAN | 992646504 | FL | Surgery Physician (208600000X) |
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 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 | 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 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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