How much does Medicare pay for CPT 93268?

Medicare allowed an average of $170.86 per service and paid $132.02 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $800.10, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93268?

Electrocardiogram (ecg) up to 30 days continuous with symptom monitoring and review and report by health care professional. It was billed 5,887 times to 5,766 Medicare beneficiaries by 214 providers in 2024.

Does 93268 pay differently in an office than a hospital?

Yes. The allowed amount averaged $170.64 in an office setting and $195.63 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 93268 most?

Cardiology, with 2,938 services from 119 clinicians. Next are Clinical Cardiac Electrophysiology, Interventional Cardiology, Neurology.

CPT 93268

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

$170.86Medicare-allowed amount per service, averaged across 5,887 services

Providers submitted

$800.10

Asking price, not received

Medicare allowed

$170.86

The fee schedule figure

Medicare paid

$132.02

Balance is patient coinsurance

Providers submitted an average of $800.10 for this code and Medicare allowed $170.86 — 4.7× 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 $132.02 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $170.64
Hospital / facility: $195.63

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 5,834 services were billed in an office setting and 53 in a facility.

Services: 5,887
Beneficiaries: 5,766
Providers billing it: 214
Total allowed: $1,005,853

What Medicare pays for CPT 93268

Across 5,887 services billed by 214 providers to 5,766 beneficiaries, Medicare allowed an average of $170.86 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 93268

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	2,938	2,898	$169.74	119
Clinical Cardiac Electrophysiology	1,032	1,015	$172.24	36
Interventional Cardiology	826	820	$160.43	26
Neurology	293	292	$170.79	13
Internal Medicine	285	283	$163.15	13
Independent Diagnostic Testing Facility (IDTF)	219	167	$214.91	2
Intensive Cardiac Rehabilitation	147	146	$199.71	1
Thoracic Surgery	86	86	$162.53	1
Emergency Medicine	37	36	$153.70	1
Family Practice	24	23	$179.15	2

93268 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	841	$194.34	$134.47	22
Florida	753	$178.65	$131.52	26
Arizona	526	$163.24	$131.12	23
Kansas	449	$152.26	$133.84	9
Maine	339	$170.79	$125.02	1
Texas	335	$166.80	$136.91	17
Connecticut	271	$187.11	$126.71	13
Pennsylvania	198	$159.79	$132.40	11
Washington	186	$169.20	$120.92	8
Oklahoma	172	$152.54	$133.88	4
New Jersey	157	$191.69	$135.78	4
New York	152	$187.49	$132.27	10
Wisconsin	140	$162.44	$134.57	5
Illinois	136	$168.81	$135.79	5
Virginia	133	$164.06	$130.71	7
Alabama	127	$143.55	$135.55	4
Rhode Island	111	$173.57	$134.99	6
South Carolina	101	$153.23	$132.43	5
Mississippi	99	$147.46	$133.48	2
Georgia	96	$142.49	$137.67	5
Michigan	94	$159.53	$129.15	5
Delaware	93	$168.23	$134.23	5
Nevada	54	$163.59	$130.74	2
Massachusetts	53	$172.28	$134.62	3
Tennessee	41	$152.46	$125.83	2
District of Columbia	40	$173.97	$114.90	2
Ohio	40	$161.39	$137.01	1
Utah	29	$149.12	$140.55	1
Maryland	26	$180.55	$128.79	1
Arkansas	26	$171.80	$136.75	1
Indiana	23	$157.12	$136.72	1
North Carolina	21	$159.21	$136.90	1
Louisiana	13	$150.97	$127.99	1
Iowa	12	$150.71	$132.07	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.