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See a sample rate comparisonCPT 93616 Fee Schedule
Last Verified: October 2026
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.
Heart Test With Probe, This Heart Test Inserts A Probe To Measure Activity Such As Flow Of Blood Through The Valves And Chambers Ability Of The Muscle To Pump (Volume) And Valve Openings And Closings. Sometimes Electrical Activity Is Recorded As Well.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $58.45 national non-facility rate (2026) · View Medicare rates for 93616 |
| Medicaid Fee Schedule | $79.77 median of the 7 states in the free preview · View Medicaid rates for 93616 |
National average reimbursement for CPT 93616 by major payers:
$364.56
$148.45
$92.47
$226.70
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CPT 93616
5 of 25 sample ratesHigher to lower in this preview
Tracy Gertler
Pediatric Faculty Foundation In
$1,060.34Published rateAdam Rappoport
The Nemours Foundation
$292.51Published rateRhonda Lampen
Multicare Health System
$132.47Published ratePeter Heydemann
Veterans Assistance Commission C
$83.81Published rateLovdie Lewis
Cardiology Consultants, P.C.
$11.68Published rate
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See a sample payer proposalCPT 93616 vs. Other Cardiovascular Procedures Codes
The CPT 93616 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 93616 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 |
|---|---|---|
| 93615-CPT | Moderate | Heart Test With Probe, This Heart Test Inserts A Probe To Measure Activity Such As Flow Of Blood Through The Valves And Chambers Ability Of The Muscle To Pump (Volume) And Valve Openings And Closings. Sometimes Electrical Activity Is Recorded As Well. |
| 93616-CPT | Moderate | Heart Test With Probe, This Heart Test Inserts A Probe To Measure Activity Such As Flow Of Blood Through The Valves And Chambers Ability Of The Muscle To Pump (Volume) And Valve Openings And Closings. Sometimes Electrical Activity Is Recorded As Well. |
| 93618-CPT | Moderate | Induced Irregular Heart Rate, Pacing Wires (Electrodes) Are Attached To The Skin To Send An Electrical Signal To The Heart. This Signal Causes An Irregularity In The Rhythm Of The Heartbeat. This Is An Evaluation Of Heart Function. |
| 93623-CPT | Moderate | Programmed Stimulation And Pac, Programmed Stimulation And Pacing After Intravenous Druginfusion (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93616. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93616 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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