CPT 93225 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 93225 |
National average reimbursement for CPT 93225 by major payers:
$31.56
$39.07
$38.08
$39.08
| 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 93225 | ||||||
United | 93225 | $25.94 | 1295736726 - MOHAMED KATERJI | 364473799 - (IL) KATERJI PEDIATRIC NEUROLOGY ASSOC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93225 | $51.29 | 1225211600 - JOHN MILLICHAP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93225 | $27.28 | 1801835202 - CHICAGO NEUROLOGY GROUP SC | 113666848 - (IL) CHICAGO NEUROLOGY GROUP, S.C. | IL | Psychiatry Physician (2084P0800X) |
United | 93225 | $77.09 | 1386755486 - DOUGLAS NORDLI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93225 | $89.18 | 1386969079 - ADAM WALLACE | 391678306 - AURORA MEDICAL GROUP INC | MN | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93225 | $35.77 | 1396945671 - REGINA HALL-NGORIMA | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 93225 | $168.71 | 1871912683 - LAUREN SCHUMACHER | 943281673 | CA | Psychiatry Physician (2084P0800X) |
United | 93225 | $49.33 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93225 | $40.16 | 1972063501 - PALOMA REINOSO | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93225 | $36.47 | 1679526784 - ELTON SMITH | 911031583 | PA | Psychiatry Physician (2084P0800X) |
United | 93225 | $42.06 | 1083979124 - RAHUL SHARMA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93225 | $40.90 | 1407807746 - SYED KHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93225 | $42.47 | 1811383334 - MAYURIKA PISE | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 93225 | $30.84 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 93225 | $40.16 | 1255692794 - MELISSA WAGNER-SCHUMAN | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
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 93225 vs. Other Cardiovascular Procedures Codes
The CPT 93225 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 93225 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) |
| 93224-CPT | Low | External Electrocardiographic Recording Up To 48 Hours By Continuous Rhythm Recording And Storage; Includes Recording Scanning Analysis With Report Review And Interpretation By A Physician Or Other Qualified Health Care Professional (Revised 01/01/13) |
| 93225-CPT | Low | External Electrocardiographic Recording Up To 48 Hours By Continuous Rhythm Recording And Storage; Recording (Includes Connection, Recording, And Disconnection) |
| 93226-CPT | Low | External Electrocardiographic Recording Up To 48 Hours By Continuous Rhythm Recording And Storage; Scanning Analysis With Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93225 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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