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 |
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 | $26.45 | 1386880227 - RISHI KAD | 251744392 | PA | Interventional Cardiology Physician (207RI0011X) |
United | 93296 | $21.68 | 1912911405 - MARK INDZONKA | 431988207 - (PA) HEART CARE OF THE POCONOS PC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $39.22 | 1265614622 - LOKESH GOWDA NANJUNDA GOWDA | 820947698 - (PA) PINNACLE HEALTH REGIONAL PHYSICIANS | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $40.59 | 1902023211 - ATHER MANSOOR | 232380812 - ST LUKES PHYSICIAN GROUP INC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $53.40 | 1922254036 - MONIKA SANGHAVI | 232743545 | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $21.68 | 1790914299 - BABAK BOZORGNIA | 205880364 - (PA) HAZLETON PROFESSIONAL SERVICES | PA | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 93296 | $64.87 | 1336119742 - MOMINA MASTOOR | 461322238 | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $28.60 | 1376586313 - ASIF HUSSAIN | 273449671 - (NJ) NEW JERSEY HEART INC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $33.40 | 1598992554 - MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC, MOUNT NITTANY PHYSICIAN GROUP | 510426500 - (PA) MOUNT NITTANY MEDICAL CENTER HEALTH SERVICES INC | PA | Internal Medicine Physician (207R00000X) |
United | 93296 | $21.68 | 1538200720 - DAVID DALESSANDRO | 232969438 - (PA) NORTHEASTERN PA CARDIOLOGY ASSOC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $34.09 | 1578900221 - GHULAM AKBAR | 232866006 - (PA) SCHUYLKILL HEALTH SYSTEM MEDICAL GROUP INC | PA | Cardiovascular Disease Physician (207RC0000X) |
United | 93296 | $34.34 | 1194883306 - READING HOSPITAL, READING HOSPITAL FAMILY HEALTH CARE CENTER | 231352204 - (PA) READING HOSPITAL | PA | Family Medicine Physician (207Q00000X) |
United | 93296 | $46.68 | 1730563628 - AKANKSHA AGRAWAL | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Advanced Heart Failure and Transplant Cardiology Physician (207RA0001X) |
United | 93296 | $28.23 | 1427043553 - RAYMOND RESNICK | 232449454 - (PA) UPMC | PA | Interventional Cardiology Physician (207RI0011X) |
United | 93296 | $29.52 | 1336128768 - JOHN SERRIAN | 204398490 | PA | 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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