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See a sample rate comparisonHealthcare 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 | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $31.73 national non-facility rate (2026) · View Medicare rates for 93296 |
| Medicaid Fee Schedule | $24.475 median of the 8 states in the free preview · View Medicaid rates for 93296 |
National average reimbursement for CPT 93296 by major payers:

$33.56

$36.73

$36.85

$51.39
Choose a payer to see a sample of rates for CPT 93296.
Lucy Webb Hayes National Training School For Deaconesses & Missionarie, Sibley Memorial Hospital
Lucy Webb Haynes National Training School For Deaconesses And Mission
Richa Agarwal
Duke Health Integrated Practice Inc
Padmini Sircar
Highmark Health
Kenneth Rosenberg
Cardiology Consultants Of Philadelphia, P.C.
Darren Traub
Warren Health Care Alliance, PC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 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 | Pm Phone R Strip Device Eval, 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 |
| 93294-CPT | Low | Rem Interrog Evl Pm Ldls Pm, Interrogation Device Evaluation S Remote Up To 90 Days Single Dual Or Multiple Lead Pacemaker System Or Leadless Pacemaker System With Interim Analysis Review S And Report S By A Physician Or Other Qualified Health Care Professional |
| 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 | Rem Interrog Evl Pm Ids, Interrogation Device Evaluation S Remote Up To 90 Days Single Dual Or Multiple Lead Pacemaker System Leadless Pacemaker System Or Implantable Defibrillator System Remote Data Acquisition S Receipt Of Transmissions And Technician Review Technical Support And Distribution Of Results |
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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