CPT 93786 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 | • None • 11 - Office |
| Common Modifiers | • None • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments • GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
National average reimbursement for CPT 93786 by major payers:
$35.53
$34.64
$41.13
$47.39
| 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 93786 | ||||||
United | 93786 | $43.90 | 1841571841 - OMOTOLA AJIBADE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | GA | Psychiatry Physician (2084P0800X) |
United | 93786 | $45.16 | 1245217942 - WALTER WHANG | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 93786 | $24.30 | 1043522899 - SHARAD KOIRALA | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93786 | $43.90 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93786 | $44.54 | 1881918415 - TUSHAR ADVANI | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 93786 | $36.40 | 1033347125 - DAVID HANRAHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93786 | $56.93 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 93786 | $40.25 | 1992234611 - USHA APPALANENI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93786 | $35.00 | 1649599168 - RESTORATIVE HEALTH REHABILITATION INC | 272533824 - (FL) RESTORATIVE HEALTH REHABILITATION INC | FL | Home Health Agency (251E00000X) |
United | 93786 | $44.93 | 1962589390 - KATHLEEN KELLEY | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93786 | $55.83 | 1386969079 - ADAM WALLACE | 363907436 - ROCKFORD HEALTH PHYSICIANS | MN | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93786 | $93.33 | 1295991701 - TRILOK SHAH | 391127163 - ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN INC | IL | Psychiatry Physician (2084P0800X) |
United | 93786 | $68.37 | 1689010373 - EWA BIEBER | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93786 | $26.89 | 1730214206 - KALYANI GAVINI | 371158318 - (IL) SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93786 | $39.90 | 1043522899 - SHARAD KOIRALA | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
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 93786 vs. Other Cardiovascular Procedures Codes
The CPT 93786 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 93786 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 |
|---|---|---|
| 93784-CPT | Low | Ambulatory Blood Pressure Monitoring Utilizing Report-Generating Software Automated Worn Continuously For 24 Hours Or Longer; Including Recording Scanning Analysis Interpretation And Report (Desc Rvsd 1/1/20) |
| 93786-CPT | Low | Ambulatory Blood Pressure Monitoring,Report-Generating Software, Automated, Worn Continuously For 24 Hours Or Longer; Including Recording, Scanning Analysis, Recording Only |
| 93788-CPT | Low | Ambulatory Blood Pressure Monitoring,Report-Generating Software, Automated, Worn Continuously For 24 Hours Or Longer; Including Recording, Scanning Analysis, Scanning Analysis With Report |
| 93790-CPT | Low | Ambulatory Blood Pressure Monitoring,Report-Generating Software, Automated, Worn Continuously For 24 Hours Or Longer; Including Recording, Scanning Analysis, Review With Interpretation And Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93786. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93786 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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