How much does Medicare pay for CPT 93280?

Medicare allowed an average of $61.84 per service and paid $45.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $189.23, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93280?

Programming of dual lead pacemaker system. It was billed 700,796 times to 528,117 Medicare beneficiaries by 7,779 providers in 2024.

Does 93280 pay differently in an office than a hospital?

Yes. The allowed amount averaged $67.97 in an office setting and $35.07 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 93280 most?

Clinical Cardiac Electrophysiology, with 320,860 services from 2,124 clinicians. Next are Cardiology, Nurse Practitioner, Interventional Cardiology.

CPT 93280

Programming of dual lead pacemaker system

$61.84Medicare-allowed amount per service, averaged across 700,796 services

Providers submitted

$189.23

Asking price, not received

Medicare allowed

$61.84

The fee schedule figure

Medicare paid

$45.25

Balance is patient coinsurance

Providers submitted an average of $189.23 for this code and Medicare allowed $61.84 — 3.1× 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 $45.25 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $67.97
Hospital / facility: $35.07

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. 570,220 services were billed in an office setting and 130,576 in a facility.

Services: 700,796
Beneficiaries: 528,117
Providers billing it: 7,779
Total allowed: $43,337,225

What Medicare pays for CPT 93280

Across 700,796 services billed by 7,779 providers to 528,117 beneficiaries, Medicare allowed an average of $61.84 per service. That is 1.3 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 93280

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	320,860	243,810	$62.13	2,124
Cardiology	256,415	188,007	$63.58	3,777
Nurse Practitioner	44,063	35,636	$51.65	640
Interventional Cardiology	40,238	29,881	$64.46	711
Internal Medicine	17,127	12,851	$60.63	219
Physician Assistant	16,769	13,656	$51.57	227
Cardiac Surgery	830	642	$60.22	14
Advanced Heart Failure and Transplant Cardiology	675	549	$57.49	12
Hospitalist	641	530	$69.62	8
Certified Clinical Nurse Specialist	573	511	$43.25	10
Undefined Physician type	469	396	$63.74	4
Family Practice	463	369	$70.05	3
Critical Care (Intensivists)	330	256	$69.93	2
Interventional Radiology	251	157	$61.76	2
Nuclear Medicine	198	145	$67.14	4

93280 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	70,810	$71.93	$46.63	897
Florida	66,460	$66.71	$49.37	735
Texas	49,285	$59.34	$44.12	548
New York	39,995	$70.42	$46.37	485
Pennsylvania	27,624	$65.79	$47.54	347
Illinois	25,465	$65.04	$46.63	218
Ohio	22,978	$54.33	$41.24	243
Arizona	22,667	$65.26	$48.94	237
Virginia	21,908	$53.14	$37.67	164
Georgia	21,779	$60.28	$45.80	176
North Carolina	20,742	$59.39	$45.39	202
New Jersey	19,858	$74.82	$49.36	194
Massachusetts	18,131	$61.61	$41.35	255
Tennessee	17,993	$57.74	$44.42	188
Michigan	17,093	$51.39	$37.50	224
South Carolina	16,825	$61.42	$47.24	206
Indiana	15,102	$63.12	$47.74	134
Missouri	13,797	$54.77	$41.58	191
Maryland	13,421	$73.75	$49.97	120
Washington	12,232	$64.81	$44.27	152
Kansas	11,207	$49.94	$38.92	91
Arkansas	11,116	$44.41	$34.21	97
Minnesota	10,462	$58.43	$41.40	84
Wisconsin	10,428	$50.37	$37.19	132
Alabama	9,951	$56.95	$44.46	125
Kentucky	9,070	$57.51	$43.90	118
Mississippi	8,728	$53.11	$40.68	76
Connecticut	8,053	$63.57	$42.61	111
Oklahoma	7,816	$50.59	$38.75	91
Colorado	7,714	$68.13	$47.81	106
Nevada	7,247	$69.91	$50.13	67
Iowa	6,743	$46.50	$35.88	68
Oregon	6,699	$55.67	$38.80	91
Louisiana	6,554	$59.71	$46.41	115
Nebraska	5,612	$57.75	$45.28	43
Utah	4,103	$63.73	$48.50	55
Montana	3,622	$59.67	$42.49	25
West Virginia	3,119	$41.08	$30.38	41
Delaware	3,024	$61.54	$42.83	38
North Dakota	2,962	$37.62	$26.84	17
New Hampshire	2,842	$43.81	$31.55	35
Idaho	2,554	$43.91	$32.70	37
District of Columbia	2,368	$71.05	$47.25	21
New Mexico	2,347	$43.42	$30.89	33
Maine	2,249	$39.56	$27.63	38
South Dakota	2,147	$36.46	$26.43	21
Vermont	1,877	$39.92	$27.96	15
Rhode Island	1,873	$54.63	$38.37	30
Alaska	1,676	$71.37	$40.97	8
Hawaii	1,250	$53.26	$36.98	18
Wyoming	1,108	$71.74	$51.95	12
Puerto Rico	110	$75.50	$50.85	4

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
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
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.