CPT 93296 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 • 49 - Independent Clinic |
| 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 93296 |
National average reimbursement for CPT 93296 by major payers:
$33.56
$36.73
$36.85
$51.28
| 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 93296 | ||||||
United | 93296 | $29.52 | 1972505618 - ROBERT BELASCO | 232076152 - (PA) CARDIOLOGY CONSULTANTS OF PHILADELPHIA, P.C. | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $17.42 | 1679602288 - DARREN TRAUB | 223837316 - WARREN HEALTH CARE ALLIANCE, PC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $19.13 | 1528569381 - NIZAR AL-SALAMEH | 160743134 - ROCHESTER GENERAL HOSPITAL | NY | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $59.09 | 1275917361 - MUSHTAQUE AHMED | 232359401 - MAIN LINE HEALTHCARE | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $50.33 | 1134581143 - MICHAEL BASHLINE | 232919472 - UPMC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $67.00 | 1053334649 - ANIL GUPTA | 232349341 - FAMILY CARE CENTERS INC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $19.68 | 1508815366 - SHARON WEIL-CHALKER | 232804614 - (PA) PERINATAL CARDIOLOGY CONSULTAN | DE | Pediatric Cardiology Physician (2080P0202X) |
United | 93296 | $34.34 | 1194883306 - READING HOSPITAL, READING HOSPITAL FAMILY HEALTH CARE CENTER | 231352204 - (PA) READING HOSPITAL | PA | Family Medicine Physician (207Q00000X) |
United | 93296 | $29.52 | 1184733065 - KENNETH ROSENBERG | 232076152 - (PA) CARDIOLOGY CONSULTANTS OF PHILADELPHIA, P.C. | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $26.45 | 1356754949 - VARUN AVULA | 251441961 - BUTLER MEDICAL PROVIDERS | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $62.97 | 1891731998 - AHS HOSPITAL CORP., MORRISTOWN MEDICAL CENTER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Psychiatric Hospital Unit (273R00000X) |
United | 93296 | $37.70 | 1356599732 - CENTRAL DUPAGE IMAGING CENTER LLC | 260404734 - (IL) CENTRAL DUPAGE IMAGING CENTER LLC | IL | Radiology Clinic/Center (261QR0200X) |
United | 93296 | $50.33 | 1124280573 - ALICIA TOPOLL | 232919472 - UPMC | IN | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $37.70 | 1144218462 - REGIONAL DIAGNOSTICS, LLC | 650718594 | IL | Radiology Clinic/Center (261QR0200X) |
United | 93296 | $25.17 | 1013194711 - VALAINE HEWITT | 232696460 - (PA) HR PHYSICIAN SERVICES | NY | 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 93296 vs. Other Cardiovascular Procedures Codes
The CPT 93296 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 93296 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 |
|---|---|---|
| 93293-CPT | Low | Transtelephonic Rhythm Strip Pacemaker Evaluation(S) Single Dual Or Multiple Lead Pacemaker System Includes Recording With And Without Magnet Application With Analysis Review And Report(S) By A Physician Or Other Qualified Health Care Professional Up To 90 Days (Revised 01/01/13) |
| 93294-CPT | Low | Interrogation Device Evaluation(S) (Remote) Up To90 Days; Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System With Interim Analysis Review(S) And And Report(S) By A Physician Or Other Qualified Health Care Professional (Desc Rvsd 1/1/19) |
| 93295-CPT | Low | Interrogation Device Evaluation(S) (Remote) Up To90 Days; Single Dual Or Multiple Lead Implantable Defibrillator System With Interim Analysis Review(S) And Report(S) By A Physician Or Other Qualified Health Care Professional (Revised 01/01/15) |
| 93296-CPT | Low | Interrogation Device Evaluation(S)(Remote) Up To 90 Days; Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System Or Implant- Able Defibrillator System Remote Data Acuisi- Tion(S) Receipt Of Transmissions And Technician Review Technical Support And Distribution Of Results (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 93296. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93296 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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