CPT 93291 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 • 26 - Professional component • XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
National average reimbursement for CPT 93291 by major payers:
$58.59
$53.84
$61.44
$82.73
| 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 93291 | ||||||
United | 93291 | $75.98 | 1952387318 - MELANY DANEHY | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93291 | $48.02 | 1710206545 - NEIL JARIWALA | 910844563 | GA | Psychiatry Physician (2084P0800X) |
United | 93291 | $46.38 | 1730263617 - MARK ALTER | 811324691 | VA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93291 | $83.04 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93291 | $81.22 | 1932272952 - MOHAMMED HOMSI | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93291 | $76.66 | 1992122410 - DIVAKAR MITHAL | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93291 | $35.33 | 1356608988 - TRIXIE LIPKE | 391157876 - BEAVER DAM COMMUNITY HOSPITALS INC | IL | Psychiatry Physician (2084P0800X) |
United | 93291 | $35.72 | 1033347125 - DAVID HANRAHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MN | Psychiatry Physician (2084P0800X) |
United | 93291 | $39.22 | 1326579756 - TONY TU | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93291 | $21.39 | 1588012058 - ALEXANDRIA MELENDEZ-ZAIDI | 752668018 | TX | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93291 | $45.31 | 1730246067 - SENADA BAJMAKOVIC-KACILA | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 93291 | $143.80 | 1275832438 - ADAM RAPPOPORT | 590634433 - THE NEMOURS FOUNDATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93291 | $34.50 | 1710244991 - ALBA PERGJIKA | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93291 | $15.14 | 1265883375 - JOCELYN LORENZO | 726000821 | LA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93291 | $24.90 | 1881012235 - LAUREN PREST | 910843135 | 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 93291 vs. Other Cardiovascular Procedures Codes
The CPT 93291 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 93291 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 |
|---|---|---|
| 93286-CPT | Low | Peri-Procedural Device Evaluation (In Person) And Programming Of Device System Parameters Before Or After A Surgery Procedure Or Test With Analysis Review And Report By A Physician Or Other Qualified Health Care Professional; Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System (Desc Rvsd 1/1/19) |
| 93288-CPT | Low | Interrogation Device Evaluation (In Person) With Analysis Review And Report By A Physician Or Other Qualified Health Care Professional Includesconnection Recording And Disconnection Per Patient Encounter; Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System (Desc Rvsd 1/1/19) |
| 93289-CPT | Low | Interrogation Device Evaluation (In Person) With Analysis Review And Report By A Physician Or Other Qualified Health Care Professional Includesconnection Recording And Disconnection Per Patient Encounter; Single Dual Or Multiple Lead Transvenous Implantable Defibrillator System Including Analysis Of Heart Rhythm Derived Date Elements (Revised 01/01/15) |
| 93291-CPT | Low | Interrogation Device Evaluation (In Person) With Analysis Review And Report By A Physician Or Other Qualified Health Care Professional Includesconnection Recording And Disconnection Per Patient Encounter; Subcutaneous Cardiac Rhythm Monitor System Including Heart Rhythm Derived Data Analysis (Desc Rvsd 1/1/19) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93291 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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