How much does Medicare pay for CPT 93286?

Medicare allowed an average of $18.45 per service and paid $14.26 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $84.24, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93286?

Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery. It was billed 25,218 times to 14,784 Medicare beneficiaries by 416 providers in 2024.

Does 93286 pay differently in an office than a hospital?

Yes. The allowed amount averaged $40.50 in an office setting and $13.94 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 93286 most?

Clinical Cardiac Electrophysiology, with 13,821 services from 239 clinicians. Next are Cardiology, Physician Assistant, Nurse Practitioner.

CPT 93286

Programming of single, dual, or multiple lead or leadless pacemaker system before or after surgery

$18.45Medicare-allowed amount per service, averaged across 25,218 services

Providers submitted

$84.24

Asking price, not received

Medicare allowed

$18.45

The fee schedule figure

Medicare paid

$14.26

Balance is patient coinsurance

Providers submitted an average of $84.24 for this code and Medicare allowed $18.45 — 4.6× 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 $14.26 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $40.50
Hospital / facility: $13.94

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. 4,280 services were billed in an office setting and 20,938 in a facility.

Services: 25,218
Beneficiaries: 14,784
Providers billing it: 416
Total allowed: $465,272

What Medicare pays for CPT 93286

Across 25,218 services billed by 416 providers to 14,784 beneficiaries, Medicare allowed an average of $18.45 per service. That is 1.7 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 93286

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	13,821	7,856	$16.77	239
Cardiology	5,424	3,212	$21.03	97
Physician Assistant	2,275	1,283	$12.92	26
Nurse Practitioner	2,118	1,471	$17.57	32
Diagnostic Radiology	840	557	$48.95	6
Internal Medicine	467	263	$17.09	11
Certified Clinical Nurse Specialist	135	57	$13.14	1
Family Practice	45	20	$13.80	1
Interventional Cardiology	43	27	$14.61	1
Vascular Surgery	33	21	$14.40	1
Undefined Physician type	17	17	$13.62	1

93286 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	2,166	$26.48	$18.15	26
Florida	2,015	$25.23	$19.88	20
Pennsylvania	1,990	$19.45	$14.61	32
New York	1,921	$23.17	$15.58	28
Massachusetts	1,835	$16.86	$12.07	34
Minnesota	1,832	$24.09	$18.09	29
Virginia	1,637	$13.86	$10.55	25
Arizona	1,507	$15.64	$11.90	11
Wisconsin	1,057	$15.14	$11.73	26
Illinois	945	$13.45	$9.88	16
Utah	890	$11.95	$9.43	10
Georgia	703	$16.02	$12.52	15
North Dakota	693	$13.92	$10.81	5
Ohio	660	$13.85	$10.90	18
Texas	572	$14.12	$10.85	15
Kansas	567	$13.95	$10.96	9
Michigan	529	$14.06	$11.01	16
Alaska	438	$16.42	$10.59	4
Maryland	356	$17.52	$12.40	4
New Hampshire	311	$15.24	$11.35	7
Oregon	309	$13.19	$8.93	5
Washington	290	$14.81	$10.98	5
Montana	285	$14.23	$10.64	6
South Carolina	254	$13.66	$11.19	6
Maine	242	$18.25	$12.19	7
Connecticut	167	$13.19	$9.76	3
North Carolina	166	$13.90	$11.05	7
Colorado	162	$14.36	$10.78	3
New Jersey	140	$22.67	$16.11	4
Arkansas	104	$13.54	$11.18	3
Tennessee	81	$13.36	$11.05	2
Rhode Island	66	$14.01	$11.21	1
Idaho	59	$13.53	$9.93	1
Delaware	57	$42.17	$32.92	1
South Dakota	44	$13.80	$11.20	2
Vermont	38	$13.82	$11.18	3
Nevada	32	$44.11	$35.23	1
Kentucky	30	$12.61	$9.24	2
District of Columbia	22	$47.54	$32.00	1
Indiana	21	$13.57	$10.66	1
Wyoming	14	$11.91	$9.54	1
Missouri	11	$13.55	$11.20	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.