How much does Medicare pay for CPT 93016?

Medicare allowed an average of $20.06 per service and paid $15.07 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $90.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93016?

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician. It was billed 705,617 times to 701,885 Medicare beneficiaries by 10,617 providers in 2024.

Does 93016 pay differently in an office than a hospital?

Yes. The allowed amount averaged $20.28 in an office setting and $19.99 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 93016 most?

Cardiology, with 468,758 services from 6,763 clinicians. Next are Interventional Cardiology, Nurse Practitioner, Internal Medicine.

CPT 93016

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician

$20.06Medicare-allowed amount per service, averaged across 705,617 services

Providers submitted

$90.22

Asking price, not received

Medicare allowed

$20.06

The fee schedule figure

Medicare paid

$15.07

Balance is patient coinsurance

Providers submitted an average of $90.22 for this code and Medicare allowed $20.06 — 4.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $15.07 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $20.28
Hospital / facility: $19.99

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 152,372 services were billed in an office setting and 553,245 in a facility.

Services: 705,617
Beneficiaries: 701,885
Providers billing it: 10,617
Total allowed: $14,154,677

What Medicare pays for CPT 93016

Across 705,617 services billed by 10,617 providers to 701,885 beneficiaries, Medicare allowed an average of $20.06 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 93016

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	468,758	466,271	$20.44	6,763
Interventional Cardiology	81,529	81,163	$20.12	1,430
Nurse Practitioner	56,414	56,077	$17.25	789
Internal Medicine	39,926	39,659	$20.39	679
Physician Assistant	20,814	20,714	$17.20	305
Diagnostic Radiology	8,074	8,050	$21.14	93
Nuclear Medicine	7,962	7,926	$21.05	59
Clinical Cardiac Electrophysiology	6,276	6,243	$20.45	160
Advanced Heart Failure and Transplant Cardiology	5,039	5,030	$20.28	89
Family Practice	4,244	4,205	$20.09	111
Hospitalist	2,650	2,633	$20.53	62
Cardiac Surgery	855	852	$20.15	13
Certified Clinical Nurse Specialist	552	548	$17.05	6
Interventional Radiology	473	471	$20.14	8
Independent Diagnostic Testing Facility (IDTF)	431	431	$20.45	4

93016 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Illinois	39,644	$20.56	$15.25	497
Florida	39,277	$20.15	$15.18	677
California	39,006	$21.42	$15.36	634
Ohio	38,925	$19.74	$15.00	574
Texas	36,561	$19.82	$15.17	585
Pennsylvania	34,131	$20.03	$14.97	581
New York	32,967	$21.69	$15.16	507
New Jersey	30,914	$21.57	$14.66	406
Massachusetts	27,678	$20.82	$14.66	320
Indiana	26,478	$19.23	$14.80	333
Georgia	25,927	$19.63	$14.90	427
Tennessee	24,932	$19.61	$15.13	302
Missouri	22,839	$19.57	$15.04	256
Michigan	22,351	$20.17	$15.06	410
North Carolina	19,103	$19.39	$14.98	355
Virginia	15,721	$20.20	$15.15	238
South Carolina	14,549	$18.87	$14.60	170
Wisconsin	14,492	$19.26	$14.44	270
Oklahoma	14,158	$19.40	$15.18	159
Washington	13,938	$19.99	$14.39	212
Minnesota	12,525	$20.16	$14.70	227
Arkansas	10,923	$19.33	$15.05	111
Kansas	10,766	$19.35	$15.13	144
Kentucky	10,197	$18.96	$14.59	160
Iowa	9,966	$19.11	$14.85	138
Arizona	9,650	$20.09	$15.51	147
Louisiana	9,639	$19.24	$14.93	180
Alabama	8,909	$19.42	$15.36	123
Colorado	8,641	$19.89	$14.64	147
Mississippi	8,234	$19.53	$15.16	119
New Hampshire	6,949	$19.54	$14.42	99
South Dakota	6,755	$19.10	$14.43	62
Maryland	6,326	$20.35	$14.92	122
Connecticut	5,760	$21.46	$15.15	117
West Virginia	5,460	$19.61	$14.83	78
Idaho	4,181	$19.23	$14.75	67
Utah	3,918	$17.84	$13.76	48
Maine	3,917	$19.81	$14.63	80
Nebraska	3,842	$18.42	$14.73	96
Oregon	3,663	$19.93	$14.46	87
North Dakota	3,512	$19.60	$15.01	39
Delaware	2,980	$19.57	$14.75	36
New Mexico	2,901	$20.08	$14.95	37
Montana	2,726	$18.85	$14.02	45
Nevada	2,018	$19.92	$15.08	32
Hawaii	1,838	$20.44	$14.98	45
Rhode Island	1,585	$20.89	$15.10	37
Vermont	1,178	$19.89	$14.57	25
Alaska	1,137	$25.87	$14.98	18
Wyoming	714	$19.49	$14.52	16
Guam	611	$19.70	$14.92	2
District of Columbia	359	$21.58	$15.08	9
Puerto Rico	179	$20.22	$14.29	9
XX	47	$17.19	$13.70	1
ZZ	20	$20.31	$13.80	1

Related codes

93010Routine electrocardiogram (ecg)$7.95
93000Routine electrocardiogram (ecg)$14.24
93018Exercise or drug-induced heart stress test$13.43
93015Exercise or drug-induced heart stress test$66.28
93005Routine electrocardiogram (ecg)$6.15
93042Electrocardiogram (ecg) 1 to 3 leads$6.79
93040Electrocardiogram (ecg) 1 to 3 leads$13.18
93017Exercise or drug-induced heart stress test$31.71
93041Electrocardiogram (ecg) 1 to 3 leads$6.52
93050Analysis of central arterial pressure$14.83

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.