How much does Medicare pay for CPT 93285?

Medicare allowed an average of $53.34 per service and paid $40.52 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $159.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93285?

Programming of cardiac rhythm monitor system. It was billed 31,897 times to 21,430 Medicare beneficiaries by 660 providers in 2024.

Does 93285 pay differently in an office than a hospital?

Yes. The allowed amount averaged $55.72 in an office setting and $24.62 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 93285 most?

Clinical Cardiac Electrophysiology, with 17,098 services from 322 clinicians. Next are Cardiology, Nurse Practitioner, Interventional Cardiology.

CPT 93285

Programming of cardiac rhythm monitor system

$53.34Medicare-allowed amount per service, averaged across 31,897 services

Providers submitted

$159.56

Asking price, not received

Medicare allowed

$53.34

The fee schedule figure

Medicare paid

$40.52

Balance is patient coinsurance

Providers submitted an average of $159.56 for this code and Medicare allowed $53.34 — 3.0× 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 $40.52 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $55.72
Hospital / facility: $24.62

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. 29,460 services were billed in an office setting and 2,437 in a facility.

Services: 31,897
Beneficiaries: 21,430
Providers billing it: 660
Total allowed: $1,701,386

What Medicare pays for CPT 93285

Across 31,897 services billed by 660 providers to 21,430 beneficiaries, Medicare allowed an average of $53.34 per service. That is 1.5 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 93285

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	17,098	11,746	$52.56	322
Cardiology	10,689	6,631	$55.81	225
Nurse Practitioner	1,692	1,499	$42.73	55
Interventional Cardiology	1,356	742	$62.83	24
Physician Assistant	552	444	$41.82	19
Internal Medicine	467	328	$49.00	14
Intensive Cardiac Rehabilitation	43	40	$65.96	1

93285 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	4,192	$60.75	$40.69	83
New York	3,754	$62.45	$41.06	69
Texas	3,753	$48.96	$38.34	51
New Jersey	3,015	$63.02	$43.61	32
Arizona	2,977	$53.20	$42.36	33
Florida	2,806	$49.83	$37.76	78
Pennsylvania	2,026	$46.62	$33.65	50
Illinois	1,168	$48.62	$35.55	25
Mississippi	973	$42.01	$32.17	15
Michigan	820	$49.35	$37.40	23
South Carolina	711	$39.75	$30.38	24
North Carolina	679	$43.09	$33.89	18
Virginia	586	$47.70	$33.85	20
Maryland	585	$63.22	$43.17	14
Wisconsin	450	$49.16	$36.99	17
Ohio	400	$46.66	$36.87	12
District of Columbia	369	$50.37	$37.20	4
Georgia	365	$51.70	$41.04	13
Arkansas	236	$54.36	$42.27	2
Tennessee	232	$34.83	$28.29	10
Massachusetts	199	$55.03	$39.33	8
Missouri	191	$33.32	$26.21	7
Connecticut	160	$63.52	$41.56	4
Alaska	135	$58.94	$35.32	3
Kentucky	129	$53.64	$43.52	5
Idaho	121	$30.22	$20.84	4
Wyoming	108	$57.90	$45.64	1
Utah	96	$42.15	$33.62	4
Indiana	84	$56.43	$43.79	4
Oklahoma	83	$35.96	$29.25	3
Washington	75	$57.01	$39.56	3
Colorado	69	$36.65	$25.78	3
Louisiana	61	$49.78	$42.53	3
Kansas	43	$51.64	$45.43	3
Nebraska	42	$53.59	$41.52	2
Oregon	37	$25.45	$19.02	1
Maine	34	$57.15	$39.10	1
Alabama	33	$42.38	$30.44	2
West Virginia	31	$38.78	$30.32	2
North Dakota	29	$23.88	$17.05	1
Delaware	14	$57.60	$45.80	1
Minnesota	13	$37.05	$34.61	1
New Hampshire	13	$23.77	$19.05	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.