How much does Medicare pay for CPT 93264?

Medicare allowed an average of $40.37 per service and paid $30.64 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $154.71, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93264?

Remote monitoring of pulmonary artery pressure sensor, up to 30 days. It was billed 29,608 times to 7,411 Medicare beneficiaries by 312 providers in 2024.

Does 93264 pay differently in an office than a hospital?

Yes. The allowed amount averaged $46.54 in an office setting and $31.67 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 93264 most?

Nurse Practitioner, with 11,634 services from 134 clinicians. Next are Cardiology, Advanced Heart Failure and Transplant Cardiology, Physician Assistant.

CPT 93264

Remote monitoring of pulmonary artery pressure sensor, up to 30 days

$40.37Medicare-allowed amount per service, averaged across 29,608 services

Providers submitted

$154.71

Asking price, not received

Medicare allowed

$40.37

The fee schedule figure

Medicare paid

$30.64

Balance is patient coinsurance

Providers submitted an average of $154.71 for this code and Medicare allowed $40.37 — 3.8× 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 $30.64 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $46.54
Hospital / facility: $31.67

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. 17,320 services were billed in an office setting and 12,288 in a facility.

Services: 29,608
Beneficiaries: 7,411
Providers billing it: 312
Total allowed: $1,195,275

What Medicare pays for CPT 93264

Across 29,608 services billed by 312 providers to 7,411 beneficiaries, Medicare allowed an average of $40.37 per service. That is 4.0 services per beneficiary, so this is a code patients typically receive more than once. 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 93264

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	11,634	3,203	$35.34	134
Cardiology	7,114	1,544	$43.62	63
Advanced Heart Failure and Transplant Cardiology	5,117	1,310	$44.32	53
Physician Assistant	3,033	727	$40.29	28
Interventional Cardiology	1,347	316	$46.91	18
Internal Medicine	603	116	$49.08	5
Certified Clinical Nurse Specialist	292	77	$39.20	4
Clinical Cardiac Electrophysiology	143	40	$36.41	3
Family Practice	139	36	$33.50	1
Undefined Physician type	76	15	$61.48	1
Intensive Cardiac Rehabilitation	65	16	$55.42	1
Infectious Disease	45	11	$53.76	1

93264 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
New York	4,192	$48.01	$31.49	36
Illinois	3,773	$39.27	$27.88	40
Texas	2,001	$41.29	$31.52	23
California	1,644	$49.85	$35.25	20
Connecticut	1,477	$34.03	$24.00	14
Minnesota	1,274	$42.12	$32.76	10
South Carolina	1,244	$41.49	$32.75	8
Missouri	1,128	$39.25	$29.62	10
Georgia	1,036	$35.46	$26.11	12
Kansas	960	$38.25	$30.12	9
Iowa	934	$37.45	$30.23	6
Nebraska	798	$35.78	$28.56	5
Massachusetts	753	$32.77	$24.66	5
Wisconsin	753	$30.22	$23.04	8
Virginia	729	$41.73	$30.28	15
North Carolina	701	$42.50	$33.37	8
Florida	675	$38.56	$28.83	10
Ohio	674	$31.59	$24.17	8
Pennsylvania	520	$48.46	$37.36	10
South Dakota	505	$29.08	$22.69	7
Oklahoma	478	$37.00	$30.78	6
Indiana	394	$40.71	$31.91	5
Kentucky	368	$44.90	$37.38	3
New Hampshire	314	$29.17	$23.22	2
Colorado	308	$51.42	$39.19	3
Washington	295	$50.26	$34.91	6
Michigan	243	$31.79	$22.24	3
Tennessee	224	$31.83	$25.64	4
Louisiana	223	$38.17	$28.65	3
Nevada	192	$33.92	$26.07	1
Arizona	183	$36.28	$28.38	2
North Dakota	180	$33.21	$25.00	2
Mississippi	102	$34.41	$27.31	1
Oregon	78	$52.36	$34.44	2
New Mexico	76	$33.97	$26.35	1
District of Columbia	73	$37.77	$26.23	1
Idaho	49	$34.28	$27.40	1
Maryland	30	$48.53	$40.19	1
New Jersey	27	$33.37	$22.27	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.