How much does Medicare pay for CPT 93228?

Medicare allowed an average of $24.32 per service and paid $18.96 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $94.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93228?

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional. It was billed 272,567 times to 266,208 Medicare beneficiaries by 6,252 providers in 2024.

Does 93228 pay differently in an office than a hospital?

Yes. The allowed amount averaged $24.37 in an office setting and $24.09 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 93228 most?

Cardiology, with 164,820 services from 3,917 clinicians. Next are Clinical Cardiac Electrophysiology, Interventional Cardiology, Internal Medicine.

CPT 93228

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional

$24.32Medicare-allowed amount per service, averaged across 272,567 services

Providers submitted

$94.44

Asking price, not received

Medicare allowed

$24.32

The fee schedule figure

Medicare paid

$18.96

Balance is patient coinsurance

Providers submitted an average of $94.44 for this code and Medicare allowed $24.32 — 3.9× 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 $18.96 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $24.37
Hospital / facility: $24.09

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. 224,670 services were billed in an office setting and 47,897 in a facility.

Services: 272,567
Beneficiaries: 266,208
Providers billing it: 6,252
Total allowed: $6,628,829

What Medicare pays for CPT 93228

Across 272,567 services billed by 6,252 providers to 266,208 beneficiaries, Medicare allowed an average of $24.32 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 93228

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	164,820	160,770	$24.40	3,917
Clinical Cardiac Electrophysiology	55,006	53,654	$24.47	873
Interventional Cardiology	32,681	32,094	$23.89	928
Internal Medicine	11,064	10,868	$24.51	310
Nurse Practitioner	2,701	2,650	$19.88	82
Independent Diagnostic Testing Facility (IDTF)	1,972	1,941	$26.96	7
Advanced Heart Failure and Transplant Cardiology	1,423	1,405	$24.24	42
Physician Assistant	588	584	$19.46	24
Family Practice	530	509	$24.10	23
Cardiac Surgery	479	456	$24.81	11
Hospitalist	315	305	$24.22	9
Undefined Physician type	282	277	$25.00	4
Sleep Medicine	143	139	$24.28	3
Emergency Medicine	102	102	$24.53	2
Intensive Cardiac Rehabilitation	100	98	$26.06	1

93228 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
California	31,701	$25.62	$18.80	508
Florida	28,134	$24.51	$18.89	642
New York	20,829	$26.57	$18.90	475
Texas	19,201	$23.64	$18.84	508
Arizona	13,635	$23.80	$18.89	285
Illinois	10,646	$24.90	$18.65	205
South Carolina	10,116	$23.31	$18.85	172
Ohio	9,765	$23.55	$18.74	178
Georgia	9,715	$22.87	$18.93	257
New Jersey	8,663	$25.69	$18.82	253
Virginia	8,484	$23.88	$18.81	193
Pennsylvania	8,201	$24.84	$18.67	180
Massachusetts	7,124	$25.51	$18.48	184
Tennessee	6,823	$22.38	$18.81	170
Michigan	6,717	$24.22	$18.69	176
North Carolina	6,550	$23.27	$18.71	219
Nevada	4,981	$23.86	$19.03	60
Mississippi	4,443	$22.47	$19.02	77
Alabama	4,366	$22.60	$18.66	129
Indiana	4,183	$23.11	$18.50	122
Minnesota	4,155	$24.14	$18.50	61
Missouri	3,938	$23.65	$18.75	118
Arkansas	3,771	$22.62	$18.45	87
Maryland	3,164	$24.96	$18.88	86
Oklahoma	3,125	$23.20	$18.77	69
Wisconsin	3,095	$23.30	$18.66	87
Washington	2,922	$24.31	$18.52	78
Kentucky	2,907	$23.62	$18.62	72
Connecticut	2,688	$25.51	$18.73	77
Utah	2,635	$23.75	$19.07	53
Louisiana	2,517	$22.36	$18.84	83
Kansas	2,104	$22.79	$18.73	65
Delaware	1,774	$24.02	$18.84	39
Colorado	1,328	$24.28	$18.64	51
West Virginia	1,081	$23.38	$18.48	26
Iowa	1,077	$22.91	$18.29	30
Maine	909	$24.10	$18.54	24
Montana	767	$24.22	$18.14	20
New Mexico	535	$22.24	$17.80	16
Rhode Island	529	$24.51	$19.06	16
Oregon	481	$24.19	$19.22	18
Alaska	464	$31.56	$17.95	11
Idaho	434	$23.05	$18.53	15
Wyoming	399	$24.25	$18.54	9
Vermont	399	$23.73	$18.35	9
New Hampshire	347	$24.43	$18.90	9
Nebraska	267	$22.97	$18.32	10
South Dakota	262	$23.33	$18.99	10
District of Columbia	166	$26.00	$18.92	8
North Dakota	50	$23.48	$19.26	2

Related codes

93296Evaluation of single$21.59
93294Evaluation of single$28.57
93298Evaluation of cardiac rhythm monitor system$76.45
93297Evaluation of implantable heart and blood vessel monitoring system$45.47
93280Programming of dual lead pacemaker system$61.84
93295Evaluation of single$35.37
93229Electrocardiogram (ecg) up to 30 days continuous$1018.21
93247Heart rhythm analysis and report of continous external ekg over 8-15 d$299.31
93248Heart rhythm review and interpretation of continous external ekg over$24.98
93243Heart rhythm analysis and report of continous external ekg over more t$279.98
93244Heart rhythm review$22.39
93284Programming of multiple lead implantable defibrillator system$85.19

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.