How much does Medicare pay for CPT 93242?

Medicare allowed an average of $11.62 per service and paid $8.92 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $82.86, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93242?

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days. It was billed 115,411 times to 111,089 Medicare beneficiaries by 3,123 providers in 2024.

Which specialty bills 93242 most?

Cardiology, with 65,684 services from 2,006 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Clinical Cardiac Electrophysiology, Interventional Cardiology.

CPT 93242

Heart rhythm recording continous external ekg over more than 48 hours up to 7 days

$11.62Medicare-allowed amount per service, averaged across 115,411 services

Providers submitted

$82.86

Asking price, not received

Medicare allowed

$11.62

The fee schedule figure

Medicare paid

$8.92

Balance is patient coinsurance

Providers submitted an average of $82.86 for this code and Medicare allowed $11.62 — 7.1× 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 $8.92 (77%); the rest is the patient’s coinsurance and deductible.

Services: 115,411
Beneficiaries: 111,089
Providers billing it: 3,123
Total allowed: $1,341,076

What Medicare pays for CPT 93242

Across 115,411 services billed by 3,123 providers to 111,089 beneficiaries, Medicare allowed an average of $11.62 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 93242

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	65,684	63,126	$11.89	2,006
Independent Diagnostic Testing Facility (IDTF)	16,089	15,641	$10.55	10
Clinical Cardiac Electrophysiology	12,220	11,728	$11.83	333
Interventional Cardiology	11,436	10,887	$11.37	377
Internal Medicine	5,833	5,645	$11.88	197
Nurse Practitioner	1,930	1,885	$11.06	96
Physician Assistant	810	794	$11.24	27
Family Practice	567	559	$10.83	34
Advanced Heart Failure and Transplant Cardiology	330	326	$12.61	19
Cardiac Surgery	127	122	$11.97	5
Nuclear Medicine	86	86	$12.59	6
Interventional Radiology	69	68	$11.31	2
Emergency Medicine	52	50	$11.56	3
Pediatric Medicine	50	49	$10.13	1
Peripheral Vascular Disease	27	26	$10.78	1

93242 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
Texas	14,243	$11.25	$7.83	230
California	13,083	$13.65	$8.69	345
Florida	10,766	$11.16	$8.72	278
Pennsylvania	10,028	$10.59	$7.96	178
New York	9,808	$13.56	$8.80	285
Illinois	6,245	$10.38	$7.87	79
New Jersey	5,231	$13.28	$8.82	182
Maryland	4,034	$12.37	$8.63	112
North Carolina	3,923	$10.61	$8.74	132
Tennessee	3,322	$10.48	$8.87	87
Arizona	2,693	$10.88	$8.38	80
Louisiana	2,562	$9.85	$8.78	68
Arkansas	2,114	$9.85	$9.06	55
Alabama	2,102	$9.88	$8.91	70
Virginia	2,078	$12.48	$9.02	85
South Carolina	1,953	$10.66	$8.87	77
Michigan	1,799	$11.36	$8.67	65
Ohio	1,745	$10.74	$8.95	72
Indiana	1,599	$10.58	$8.81	60
Georgia	1,587	$10.55	$8.85	50
Missouri	1,495	$10.57	$8.59	52
Washington	1,404	$12.67	$8.80	54
Massachusetts	1,258	$13.08	$9.02	54
Kentucky	1,137	$10.44	$9.03	52
Connecticut	894	$12.91	$8.90	36
West Virginia	713	$10.48	$8.77	10
Minnesota	709	$11.75	$8.82	30
Wisconsin	643	$11.02	$8.97	29
Oregon	613	$11.73	$8.77	23
Iowa	606	$10.51	$8.83	16
Nevada	575	$12.02	$8.93	16
Alaska	509	$12.62	$9.07	15
Mississippi	496	$9.82	$8.87	18
Nebraska	465	$10.27	$9.01	15
Colorado	437	$12.18	$9.01	19
Utah	425	$10.94	$8.99	16
Oklahoma	410	$10.38	$8.91	20
Kansas	355	$10.10	$8.27	12
District of Columbia	255	$13.77	$8.95	9
Delaware	250	$11.58	$8.58	8
Wyoming	185	$8.81	$7.05	1
Hawaii	151	$13.02	$7.78	6
New Mexico	102	$10.79	$8.44	5
Montana	97	$11.83	$8.36	4
New Hampshire	93	$12.14	$9.07	4
U.S. Virgin Islands	80	$11.50	$8.99	1
Maine	54	$11.44	$8.00	3
Rhode Island	36	$13.08	$8.86	2
North Dakota	25	$11.55	$7.93	1
Vermont	13	$11.00	$8.72	1
XX	11	$10.83	$7.97	1

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
93228Electrocardiogram (ecg) up to 30 days continuous$24.32
93243Heart rhythm analysis and report of continous external ekg over more t$279.98
93244Heart rhythm review$22.39

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.