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See a sample rate comparisonCPT 93226 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.
Wearable Electrocardiographic, Wearable Electrocardiographic Rhythm Derived Monitoring For 24 Hours By Continuous Original Waveformrecording And Storage With Visual Superimpositio N Scanning Scanning Analysis With Report
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments PN - Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
| Complexity Level | Low |
| Medicare Fee Schedule | $34.74 national non-facility rate (2026) · View Medicare rates for 93226 |
| Medicaid Fee Schedule | $29.945 median of the 8 states in the free preview · View Medicaid rates for 93226 |
National average reimbursement for CPT 93226 by major payers:
$55.84
$59.50
$60.61
$75.95
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CPT 93226
5 of 25 sample ratesHigher to lower in this preview
P. Daniel Le Grange
$239.67Published rateNora Ekeanya
$70.98Published rateKelly Rhodes
Riverside Health System
$62.74Published rateElizabeth Charney
The Board Of Trustees Of The University Of Illinois
$57.09Published rateNatalia Castro
Town Center Orthopaedic Associates, P.C.
$35.62Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 93226 vs. Other Cardiovascular Procedures Codes
The CPT 93226 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 93226 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 |
|---|---|---|
| 93224-CPT | Low | Ecg Monit Reprt Up To 48 Hrs, 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 |
| 93225-CPT | Low | Wearable Electrocardiographic, Wearable Electrocardiographic Rhythm Derived Monitoring For 24 Hours By Continuous Original Waveformrecording And Storage With Visual Superimpositio N Scanning Recording (Includes Connection Record |
| 93226-CPT | Low | Wearable Electrocardiographic, Wearable Electrocardiographic Rhythm Derived Monitoring For 24 Hours By Continuous Original Waveformrecording And Storage With Visual Superimpositio N Scanning Scanning Analysis With Report |
| 93227-CPT | Low | Wearable Electrocardiographic, Wearable Electrocardiographic Rhythm Derived Monitoring For 24 Hours By Continuous Original Waveformrecording And Storage With Visual Superimpositio N Scanning Physician Review And Interpretation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93226. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93226 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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