CPT 93298 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 • 49 - Independent Clinic |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 93298 by major payers:
$73.90
$40.41
$49.66
$104.74
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
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CPT 93298 vs. Other Cardiovascular Procedures Codes
The CPT 93298 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 93298 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 |
|---|---|---|
| 93294 | 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 | 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 | 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) |
| 93298 | Low | Interrogation Device Evaluation(S) (Remote) Up To30 Days; Subcutaneous Cardiac Rhythm Monitor Sys- Temincluding Analysis Of Recorded Heart Rhythm Data Analysis Review(S) And Report(S) By A Physician Or Other Qualified Health Care Professional (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 93298. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93298 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
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