CPT 93016 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 | • 22 - On Campus Outpatient Hospital • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Low |
National average reimbursement for CPT 93016 by major payers:
$29.74
$34.82
$31.47
$35.48
| 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 93016 | ||||||
United | 93016 | $32.11 | 1124089784 - DENNIS INCORVATI | 590714812 - LEE MEMORIAL HEALTH SYSTEM | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $28.51 | 1508986308 - COREY GOLDSTEIN | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 93016 | $18.87 | 1396902839 - JOSE-LUIS VELAZQUEZ-CECENA | 261869328 | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $23.15 | 1639376007 - AJAY MEHTA | 262131291 - (FL) OCALA HEART CLINIC II LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $41.70 | 1134382898 - ROBERT PIOTROWSKI | 431960221 - (OR) SALEM HEALTH WEST VALLEY | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $19.81 | 1861987836 - HEART HEALTH ASSOCIATES PA | 830532407 - (FL) HEART HEALTH ASSOCIATES PA | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $23.18 | 1215925136 - NANCY CRISTOFORO | 300578257 - (NJ) RB CARDIOLOGY READING ASSOCIATES LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $25.05 | 1033318928 - GEORGE LE-BERT | 262909414 - MILLENNIUM PHYSICIAN GROUP, LLC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $42.45 | 1811977333 - JAMES SMITH | 462021581 - (FL) FLORIDA HOSPITAL PHYSICIAN GROUP INC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $16.20 | 1326035767 - GEORGE BORDENAVE | 650424670 - (FL) GEORGE BORDENAVE MD PA | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $33.52 | 1144431123 - ERICA VEGUILLA | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93016 | $55.27 | 1891921367 - KAVITA THAKKAR | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | PA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93016 | $35.59 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | NC | Psychiatry Physician (2084P0800X) |
United | 93016 | $27.05 | 1558481770 - KOUSHIK REDDY | 237313346 - (FL) UNIVERSITY MEDICAL SERVICE ASSOCIATION INC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 93016 | $18.22 | 1265631378 - SOUTH FLORIDA INTERVENTIONAL CARDIOLOGY PA | 562668384 - (FL) SOUTH FLORIDA INTERVENTIONAL CARDIOLOGY PA | FL | Cardiovascular Disease Physician (207RC0000X) |
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 93016 vs. Other Cardiovascular Procedures Codes
The CPT 93016 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 93016 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 |
|---|---|---|
| 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) |
| 93016-CPT | Low | Cardiovascular Stress Test Using Maximal Or Submaximal Treadmill Or Bicycle Exercise Continuous Electrocardiographic Monitoring And/Or Pharmacological Stress; Supervision Only Without Interpre- Tation And Report (Revised 1/1/2013) |
| 93017-CPT | Low | Cardiovascular Stress Test Using Maximal Or Submaximal Treadmill Or Bicycle Exercise, Continuous Electrocardiographic Monitoring, And/Or Pharmacological Stress; Tracing Only, Without Interpretation And Report |
| 93018-CPT | Low | Cardiovascular Stress Test Using Maximal Or Submaximal Treadmill Or Bicycle Exercise, Continuous Electrocardiographic Monitoring, And/Or Pharmacological Stress; Interpretation And Report Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93016 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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